July 29, 2021

Getting over the Honeymoon Phase in Healthcare & properly Honoring the Hippocratic Oath.

 

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During each commencement in medical school, new doctors stand before their friends and families, reciting the words of the Hippocratic Oath simultaneously.

Their voices are filled with passion and inspiration. Their minds envision their futures, where they positively impact other people’s lives, find cures for diseases, and dream of changing the world.

As the words “I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug” (Practo) flow freely from their lips, worries over time management, patient satisfaction surveys, and metrics are somewhere in the far off distance.

You see, new doctors are still in the honeymoon phase with healthcare and have yet to consider how complicated their relationships are about to get. They’ve no idea how this complicated world of ours can impact patients. Medical school cannot prepare someone to deal with the various injustices that society hands down to certain people, nor can it prepare them for the lack of resources available for those who suffer hardships.

Although there is a movement toward a more holistic type of education in medical schools, the majority of doctors practicing today are educated under the theory of the medical model, which is part of the problem facing patient care today.

The Encyclopedia of Clinical Neuropsychology defines the medical model as:

“A model of health which suggests that disease is detected and identified through a systematic process of observation, description, and differentiation.”

Sounds simple enough to apply, doesn’t it? Identify, diagnose and treat.

But what happens when you complicate diagnosing beyond science?

What happens when the patient is not only having physiological symptoms but has additional levels of complexity due to past traumas, addictions, behavioral health diagnoses, or social barriers beyond their control?

As a nurse care coordinator for a primary care practice, my patient caseload consists of high-risk patients, both medically and psychologically.

I love my job and find so much satisfaction and fulfillment connecting with my patients. Perhaps, it is because I understand them on a personal level, having experienced my own behavioral health and addiction issues. Or maybe, it’s because my job offers me autonomy, and with that, I decide how much time I spend getting to know them. Had I not suffered from PTSD and Major Depression, I still believe I would have been able to establish healthy rapports based on my nursing education.

As a nurse, I was educated in holistic care, which addresses the “whole person,” which simply means that the patient is more than their physical illness. According to Nurse Theory.org:

“Holistic healing addresses the interconnectedness of the mind, body, spirit, social/cultural, emotions, relationships, context, and environment.”

I believe every patient in healthcare should be approached holistically, for humans are complex beings.

For a doctor to practice holistic care, though, they must see the patient as a “whole,” not a diagnosis. And there is only one way in which they can concentrate on the patient individually—in a mindful environment.

According to the Department of Family Medicine and Community Health, at the University of Wisconsin, “mindfulness is paying attention intentionally with a certain attitude (acceptance, non-judging, openness, curiosity, kindness, non-striving, patience, letting go, trust, and non-reactivity).”

Notice the similarities to the sentiments of warmth, compassion, and understanding in the Hippocratic Oath?

Yet, I can hear the doctors now…

“What? A mindful environment? I have 30 patients to see today!”

“Impossible!”

“Can’t we refer to the social worker?”

Luckily for them, not only am I a nurse and a writer, I am also a chronic optimist! I hear your impossible, doc, and I raise you ten ways we can do better.

Here are some steps you can take right now to restore mindfulness to medicine, interact with the patient holistically, and ensure all of our patients feel seen and heard.

  1. Look at your patient when you say hello.
  2. Allow your patient time to answer your questions.
  3. Show concern by encouraging elaboration.
  4. Always be honest and establish trust.
  5. Show compassion and understanding.
  6. Sit still and listen.
  7. Lean in toward the person, for body language speaks volumes.
  8. Be present and focus on the moment. (Don’t worry about what you have to do next. People know when someone is distracted.)
  9. Empower your patients by confirming they are in agreement with the treatment plan.
  10. Stay seated and never leave the room until the visit is complete.

Modern medicine and health insurance companies have created an impossible situation for the doctors providing care. However, it should not be the patients who suffer. Mindful medicine would benefit all those involved: the patients, the doctors, and the healthcare system.

Mindful interactions are fulfilling to everyone involved, and happier patients are the key to successful healthcare systems! Let us disprove the notion that the human connection between doctor and patient has been lost to the bottom line because it doesn’t have to be.

It’s simple. Follow the steps above.

And, before you enter that exam room next time, remember to stop and ask yourself, “What if this were my loved one?”

In an instant, the words of your Hippocratic Oath will echo in your ears, and nostalgia will fill your soul with newfound inspiration. Do it for your patients, but most importantly, do it for yourself.

Don’t worry, doc. You still have time to change the world, one mindful patient interaction at a time.

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