Medical Classics: The Doctor
Está aquí: Inicio · vol3 · num How thick the shield should be: Teaching the subtleties of the doctor-patient relationship using literature and popular movies. The objective of the present study was to evaluate how, over the years, the figure of the doctor and the doctor-patient relationship has evolved. The Doctor is a drama film directed by Randa Haines. It is loosely based on Dr. Edward Rosenbaum's book, A Taste Of My Own Medicine. The film stars William Hurt as Jack MacKee, a doctor who undergoes a transformation in his views about life, illness and human relationships. His "bedside manner" with his patients, in many cases seriously ill, is also.
In my opinion, the movie may be used as an educational tool to show medical students what doctors are or should be, what we do or should do, what we say or do not say and also what we should refrain from saying. A Taste of my Own Medicine: When the Doctor is the Patient The Doctor In Edward Rosembaum, a retired rheumatologist, published an autobiographical book about what happened to him after he was diagnosed with larynx cancer.
The title was self-explanatory: When the Doctor is the Patient31 Figure 5. In his book, Rosembaum explained the feelings of being diagnosed with a severe disease, the initial mistakes some colleagues made until the definite diagnosis, the long treatment and all of the feelings of uncertainties and fears that followed. The book is specially revealing about how a doctor feels when treated as a patient and how he considers the disease from the eyes of a patient after practising medicine for many years.
Additionally, the book includes several situations, such as long delays in being visited or treated, diagnostic mistakes or bureaucratic worries, which add unnecessary suffering for the patients. As the author explains, these events were not considered by him before his disease was diagnosed.
When he was obliged to adopt the role of patient, he started to consider the medical profession in a new light. The disease has deeply changed him, and many situations which were neglected in the past now have a completely new consideration.
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Contrary to Le Maladie de Sachs, this film was a rather free version that changed many of the features of the original book. Compared with the book, the movie is pure Hollywood32 and some of its scenes are purely topical about physicians.
Here, the main character is Jack McKee, a young and bright surgeon. At the beginning of the film, several scenes show how Dr. McKee is an arrogant and insensitive doctor with a cynical sense of humour that he generously applies to his patients.
He also advises the residents against getting too involved with patients and even makes jokes about a colleague, a doctor of the caring type. His marriage breaks down after his cancer diagnosis and he falls in love with a young woman afflicted with a brain tumour, who finally dies. Contrary to the literary work in which this was inspired, the movie is a personal trip through disease and the health-care system rather than a reflection on the process of becoming severely sick, with the personal consequences of this fact.
During this trip, he discovers the long waits for doctor consultations, the failures of hospital information, the mistakes of health professionals, or the delays in receiving important laboratory results. I strongly recommend that The Doctor be viewed by future physicians, as it is a good tool to discuss some topics that are ignored during the training of medical students In this way, the last scenes of the film are specially revealing.
McKee is cured, he returns to his job but is remarkably changed. When receiving his new resident physicians, he obliges them to become patients for a full day: McKee is a different man and tries to inculcate his trainees with a new way of treating their patients. The last message of Dr. McKee is to recognise that patients feel frightened, embarrassed and vulnerable, and they are so confident in their physicians that they put their life in their hands His objective is clear: In fact, some schools of Medicine have used this approach to teach their students how patients may feel Young people are generally healthy and, by the time they understand what it means to be sick themselves, many patients will have already been mistreated.
However, the thickness of this invisible shield is a critical point that is difficult to learn before having enough clinical experience, but by this time many patients have suffered from the arrogance and insensitivity of some physicians. Obviously, the sooner doctors learn about it, the better patients will be treated. However, medical educators should try to convey the need of such sensitivity in their students, and the implementation of educational activities directed to this aim should be compulsory if we wish to train better doctors.
This is a tough task and probably these young and healthy men and women, who are medical students, will not be very receptive to the message. In spite of this possibility, I think that the movies and literary works portrayed in this paper may help them to look at patients in a very different way.
References Bean WB, editor. Schuman; ; Smyth FS.
- The Doctor
- MOVIE PORTRAYALS OF PHYSICIANS AND THE DOCTOR – PATIENT RELATIONSHIP
- Doctor–patient relationship
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Med J Aust ; 2: Constant interruptions from the patient whilst the doctor is discussing treatment options and diagnoses can be detrimental or lead to less effective efforts in patient treatment.
Doctor–patient relationship - Wikipedia
This is extremely important to take note of as it is something that can be addressed in quite a simple manner. This research conducted on doctor-patient interruptions also indicates that males are much more likely to interject out of turn in a conversation then women.
These may provide psychological support for the patient, but in some cases it may compromise the doctor—patient confidentiality and inhibit the patient from disclosing uncomfortable or intimate subjects. When visiting a health provider about sexual issues, having both partners of a couple present is often necessary, and is typically a good thing, but may also prevent the disclosure of certain subjects, and, according to one report, increases the stress level.
Family members, in addition to the patient needing treatment may disagree on the treatment needing to be done. This can lead to tension and discomfort for the patient and the doctor, putting further strain on the relationship. Bedside manner[ edit ] The medical doctor, with a nurse by his side, is performing a blood test at a hospital in A good bedside manner is typically one that reassures and comforts the patient while remaining honest about a diagnosis. Vocal tones, body languageopenness, presence, honesty, and concealment of attitude may all affect bedside manner.
Poor bedside manner leaves the patient feeling unsatisfied, worried, frightened, or alone. Bedside manner becomes difficult when a healthcare professional must explain an unfavorable diagnosis to the patient, while keeping the patient from being alarmed. Rita Charon launched the narrative medicine movement in with an article in the Journal of the American Medical Association.
In the article she claimed that better understanding the patient's narrative could lead to better medical care. First, patients want their providers to provide reassurance. Third, patients want to see their lab results and for the doctor to explain what they mean. Fourth, patients simply do not want to feel judged by their providers. And fifth, patients want to be participants in medical decision-making; they want providers to ask them what they want. Please help improve this article by adding citations to reliable sources.
July Learn how and when to remove this template message Dr. Gregory House of the show House has an acerbic, insensitive bedside manner. However, this is an extension of his normal personality. In Grey's AnatomyDr. George O'Malley 's ability to care for Dr. Bailey's baby by saying "it speaks to a good bedside manner. In LostHurley tells Jack Shephard that his bedside manner "sucks".
Later in the episode, Jack is told by his father to put more hope into his sayings, which he does when operating on his future wife. The comments continue in other episodes of the series with Benjamin Linus sarcastically telling Jack that his "bedside manner leaves something to be desired" after Jack gives him a harsh negative diagnosis.
In CloserLarry, the physician tells Anna when they first meet that he is famed for his bedside manner. In ScrubsJ. D is presented as an example of a physician with great bedside manner, while Elliot Reid is a physician with bad or non-existent bedside manner at first, until she evolves during her tenure at Sacred Heart. Cox is an interesting subversion, in that his manner is brash and undiplomatic while still inspiring patients to do their own best to aid in the healing process, akin to a drill sergeant.
This show also comically remarked that the most amount of time that a doctor needs to be in the presence of the patient before he finds out everything he needs to know is approximately 15 seconds.
Voyagerthe Doctor often compliments himself on the charming bedside manner he developed with the help of Kes. Hunnicuttand Sherman Potter all possess a caring and humorous bedside manner meant to help patients cope with traumatic injuries.
Charles Winchester initially possesses no real bedside manner, acting with detached professionalism, until the rigors of his job help him develop a sense of compassion for his patients. Frank Burns has a poor bedside manner, constantly minimizing the seriousness of his patients' injuries, accusing them of cowardice and goading them to return to the front lines. Patient behavior[ edit ] The behavior of the patient affects the doctor—patient relationship.
Rude or aggressive behavior from patients or their family members can also distract healthcare professionals and cause them to be less effective or to make mistakes during a medical procedure.