Friends directed me to a couple of great articles related to how physicians interact with patients. Docs are taught to be objective, non-directive, open, responsive and entirely focused on the needs of the patients. But not always…
One article suggests that when we physicians personally have a medical condition, we aren’t always objective regarding the needs of our patients with the same condition. A recent study in Obesity suggests that overweight or obese physicians may avoid discussing obesity issues with similarly challenged patients. Not even “do as I say, not as I do,” but rather, “let’s not bring up the issue at all.” The authors found that only seven percent of overweight and obese physicians recorded an obesity diagnosis for their obese patients compared to 93 percent of normal weight docs (defined by a body mass index or BMI of <25). And the lack of counseling for diet or exercise follows suit.
The other article speaks to end-of-life care and physician counseling. Ken Murray, MD, relates in How Doctors Die personal stories from his practice and family experiences. This is not a scientific study, but its conclusion certainly reflects my observations. We healthcare professionals know what we want to happen and not happen. And less is more. And we feel it passionately! Yet, when asked by patients and families “what would you do” in situations of terminal disease, we dodge the answer, falling back on our objectivity and being supportive mandate. Somehow, I’m not sure that is the best answer (while supporting what the patient/family wants). Futile care in this country is a tragedy on many levels.
During my medical career as a Maternal Fetal Medicine physician, I was honored to both celebrate new life and support the tragedy of family loss. Did my personal preference (what I would do in a similar situation) direct patient decision-making? I do remember responding more than once to a plea from a family by saying “I don’t know.”
A big part of being a physician is being human.