Medicine is an imperfect science, coupled with the art of human experiences. The experience of the physician and the patient both come into play. But unfortunately, we often ignore how these points of view come together, creating a struggle between the needs of the physician and the patient.
As we continuously strive to treat and diagnose those that have entrusted their lives in our care, we continuously ask ourselves as physicians, how much do I tell patients? When do I tell them certain things, and how do I communicate the whole concept of differential diagnosis and not always having the answers immediately? As a physician, I do not want to cause too much, or not enough, concern. I do not want to burden patients with what I might be worried about when it might not be correct.
But all of those concerns are actually about me. I am worried about what my patient might think of me. I am worried about protecting someone in a manner that might be completely inconsistent with their wants. Even though I might have the best intentions, and truly believe I am doing what is in the best interest of my patient, who am I to say what is in the best interest of my patient when it comes to information sharing? If I stepped back and looked at being in a true relationship as a trusted partner, I would look at this dilemma much differently. I would ask myself how I can find out the best way to handle these difficult issues from a relational perspective. This is where the art of medicine comes into play. How do I paint a picture for my partner in a manner that is appealing to them? How do I broach subjects in a way that includes their desired level of information?
If I want to be in communion with those I serve, I need to focus on how I communicate with my patients. I must ask them how much of my thought process do they want to hear. I am sure most of my patients would rather I share more than less. The discussions are about them, not me. If I have a concern that a diagnosis might be bad, and share that concern, when I have a conversation that includes such information, it does not catch them so off guard. Whether I have such conversations with my patient directly or with a family member, I must always remember who my partner is, and how I should take their desires into account.
Interestingly, when I have such conversations, it has led to a deeper relationship with my patient which is why I chose to practice in the first place. Even if I am unable to provide a solution or treatment from a medical perspective, such communication is a treatment. It is the ultimate human treatment, dignity and respect. I have been blessed to be part of so many lives which is so different than being part of just being their diagnostician. This covenant that I share with my patients is my reward and how I should measure my success.