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March 20, 2006 --
What makes a good doctor?
I'm sure many reading this have strong opinions as to how to answer this
questions.
Is it bedside manner? Is it
making the patient feel everything will be ok? Is it having
world-class technical skills? Or is it a combination of all these
traits?
A recent publication in the
journal Mayo Clinic Proceedings got significant media attention because a
group of researchers tried to answer this exact question. The team, a
multi-disciplinary group of doctors and business types, surveyed 192 people
who had recently been seen at the Mayo Clinics in Minnesota and Arizona.
The recent patients were surveyed
by phone and asked the following:
1) Tell me about the best
experience you had with a doctor in the Mayo system.
2) Tell me about the worst experience you had with a doctor in the Mayo
system.
3) Think about all the people you interacted with at the clinic other than
doctors. Tell me about the best experience you had with any of them.
4) Tell me about the worst experience you had with any of them.
5) If you could make one change to improve the patient experience at Mayo
Clinic, what would it be and why?
The respondents were encouraged
to provide detailed specific examples of their experience with the Mayo
Clinic doctors. The responses were then reviewed by two separate
researchers to identify themes representative of the behaviors described in
the answers. The two researchers compared their lists, resolved any
differences, then went back over the responses again and tabulated the
number of times each theme was mentioned. To check their analysis, two
other researchers independently reviewed and coded the responses and their
results were compared with the original coders.
Out of this, the researchers
identified 7 attributes which were used to describe the best physician
experiences:
-
Confident - the doctor's manner
created a sense of trust
-
Empathetic - the doctor tried to
understand what the patient was feeling
-
Humane - the doctor was caring,
compassionate, and kind
-
Personal - the doctor was
genuinely interested in the patient as a person and individual
-
Forthright - the doctor discussed
the facts in plain language
-
Respectful - the doctor took the
patient seriously and accepted input
-
Thorough - the doctor was
conscientious and persistent
Any guesses as to which of these
attributes was mentioned most often?
Believe it or not thorough was
the most commonly mentioned attribute, while empathetic was the least.
Interestingly, only about half
the group was able to recall a worst experience, but those that could often
described the complete opposite of the traits listed above. Arrogance,
insensitivity, disinterest, impatient, and callousness were words typically
used to describe negative physician experiences.
So where do technical skills as a
doctor fit into the mix? The authors of this study noted the
conspicuous absence of this trait and speculate that it can be difficult for
patients to evaluate the actual technical skills of a physician and so
instead rely on other factors which they can interpret. Another way of
looking at it is that patients assume a certain level of technical
competence in all doctors, unless there is evidence to the contrary.
Based on the many personal
stories this publication has received and published, I think this survey
does reflect a lot of the traits which many people like to see in a doctor.
However, I also think it misses
one important point. Each person/patient is unique and so is each
doctor. The trick is not in finding the "best doctor" in an objective,
scorecard way, but in finding the best doctor for you, which is completely
subjective. A doctor who may be great for one person, may not be a
good fit for another. One person may want to travel 1,000 miles to go
to a specialty clinic, but someone else may be more comfortable close to
home. Everyone is different.
If you're looking for a doctor,
first understand yourself as a patient and what is important to you.
Second, talk to as many people as you can and do your homework, but don't
let other people tell you what to do. Third, meet with more than one
so you get a feel for their differences in approach and personality.
Finally, pick the one that fits you as a patient the best.
In the end some decisions need to
be made based on instinct and gut feel. In my opinion, this is one of
those times.
-- Rick Labuda
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