Missing a"C"

After a year on the AMA tour of my state, I have decided that medicine isn't what it used to be. No longer is the doctor a member of your town, the guy you run into at the grocery store, the one who knows your family history because he knew and treated most of your family. Doctors no longer make house calls. They don't listen to the words that aren't coming out of your mouth. They don't read your verbal cues and sometimes, they don't even register the actual words coming out of your mouth. In an effort to move medicine along, I think we've lost some of what made old time medicine great. Yes, we didn't have 18 zillion tests or specialists so versed in an area they could acurately diagnose what used to be a life threatening disease. We did have compassion.

Merriam-Webster defines compassion as "sympathetic consciousness of others' distress together with a desire to alleviate it". Let's break this into two parts. I wholeheartedly believe every doctor has the desire to alleviate the distress of their patient. What drive that desire may be a debate for another time, but whether it be to make someone less distressed, to increase reputation or ego or to increase revenue I believe all doctors have it.

It's the first part of "compassion" I believe most doctors have lost. Doctors run through patients in a day b/c of a "minimum" they have to see or a schedule based on 15 minute appointments to fit the maximum people into a day for whatever reason (in a private practice, maybe it's money. Maybe it's an insurance requirement. I don't know the behind the scenes in most private arenas, so I hesitate to guess. I do know in a lot of orthopedic mega-groups minimum patient numbers per day are required). They stream one into the next and I'm sure the day just blurs into one big complaint. If you multiply that over a 20 year career, I can't imagine the amount of caring that seeps from your bones. I can also believe when you've seen your 80th zillion torn ACL or diabetic onset it's hard to muster any emotion. It must not even occur to you that when you zip into a room, tell a patient "Yep. Looks like diabetes", hand them a prescription, refer them to a nutritionist/diabetes expert, tell them you'll see them in 6 months and zip out the person on the other end has just had their life turned upside down. An athlete with an ACL tear loses their season (or multiple seasons in most high school athletes), their livelihood, they identity. They haven't had this happen to them 80 zillion times. This is it. The one. The only. Their head is spinning, their life is changing and the person who has all the answers to the million questions forming in their head just abandoned them to zip on to the next patient. Where did the sympathetic consciousness go?

Perhaps I am hard on our medical profession. From my mindset, I just don't understand it. I am currently seeing between 30-35 "patients" (athletes) in a 1 hour time frame. Granted, most of them are repeat customers. They are fairly self-sufficient needing me sometimes for taping, moving their treatment forward or just to rearrange the bodies in the room so everyone fits. Still, I make sure to "check-in" with even these athletes. "Is that heat/ice working?" "How are you feeling?" "Better, worse or the same?" Even in the midst of chaos, I remind myself to take a second to make the athletes feel like they are cared for. That they aren't just one speck in the whirlwind of chaos coming through the room. It takes me 5 seconds. I make eye contact and listen to a brief answer. I always hope that it's enough. For the athletes coming in for the first time, well, they get pushed to the end of the whirlwind. Sort of an Athletic Trainer triage. I want to take time to talk to them, explain to them and not just point them in a direction and zip on to the rest. I try to remember that it might be my 80 zillionth knee cap pain, but it's the first one for them. Their pain is real. Often confused and frustrated and looking for answers. I want to try and give it to them. If that means my 1 hour time frame extends to 1 hour and 15 minutes, oh well.

I know my job and that of a doctor are greatly different. I can't imagine how hard their days are. (Today, I spent 3.5 hours in the sunshine watching a baseball scrimmage and treating a few people along the way. Can't complain. :) ) I just wish they would start every day reminding themselves that the patients they are about to see are people. Humans. Sometimes scared, sometimes confused, sometimes frustrated and looking to them for answers. Perhaps we need to remind doctors about the definition of compassion.