“Compassion can not only help patients recover, it also makes the physician’s own life much better”April 4, 2020
A young doctor, a new graduate from a medical school in India, will be well versed in taking the history, and making a thorough physical examination of a patient. He would have taken his final examination on young adults or on children. But in later life, in a busy outpatient clinic of a hospital with several hundred persons demanding his attention equally, he may feel exasperated and frustrated that he cannot communicate with this old person in a wheelchair.
The person may be deaf, immobile, unable to get on the examination table, rambling in his answers or unable to answer briskly the questions asked.
Healthcare has become very mechanical these days. Doctors no longer have time to sit and chat, answer questions or put fears at rest, unlike the family physicians of yesteryears. In our student days, we would be taken severely to task by our teachers if we did not have a clinical diagnosis first. We had to justify every investigation. Doctors trained to use their eyes, hands and ears, their hearts and brains, before asking for any test, earn the confidence and respect of the patient.
‘New-gen’ doctors should be taught to be clinicians first and not embrace technology too quickly. Society’s distrust of doctors will vanish only if the doctor is perceived as a friend, not subservient to an angiogram or an MR scan, performed without adequate explanation. Technology, after all, is a good slave, but a bad master.
Sir William Osler, an all-time great teacher, once said that as he grew older, he used a lower and lower number of medicines. He was the one who taught the basic steps of physical examination – inspection, palpation, percussion and auscultation, followed by ‘contemplation’. Sadly, clinical examination is in decline the world over. Alas, this is what an older person seeks when he comes to his doctor in search of a cure, not a battery of tests and a long list of pills. A doctor is perceived as a ‘wise person’ who will listen and give sage advice, take time with the patient, do a full examination and prescribe the least number of medicines. This is the task of the geriatrician in these days of sophistication and specialisation – a physician who can show understanding. This makes the patient recover faster and makes the doctor’s own life more satisfying.
— As told to Divya Choyikutty