What’s Important Doesn’t Change

Rolf Benirschke, the former kicker for the San Diego Chargers Football Team and the speaker at the School of Medicine graduation today spoke quietly and  made an impression on everyone there.  As a long time patient, he acknowledged the faculty for having saved Screen Shot 2016-06-05 at 11.01.28 PMhis life many years ago.  Then, he turned his attention to the graduates – those who will be called, “Doctor,” for the rest of their lives.  He reminded them that each patient will have four questions for them – even if they aren’t articulated clearly or even spoken out loud.

The first question is, “Can I trust you?”  Can I trust you to be honest, compassionate and caring when I tell you my most important thoughts and concerns?  Second, they will ask, “Are you committed to excellence?”  Do you strive to continue to learn and integrate new medical knowledge so my care is appropriate and up to date?  Are you dedicated to being the best at what you do?  Next, they will wonder, ” Do you care about me as a person?” Do you see me as the unique person I am, or am I just another gall bladder or rash to you?  Do the particulars of my life matter to you as you care for my medical conditions?  And last, they will want to know if there is hope.  We all need hope.

The sheer amount of knowledge and experience that we pack into four years of medical school often makes it difficult to acknowledge these human aspects of medical care.  Yet, they are essential foundations of the care we provide.

As I write, I am aware that only six days remain on my schedule to see patients.  Having spent the last few years caring for patients, teaching medical students and coaching physicians who are burned out or struggling with aspects of being a doctor, I’ve known  that I needed to give up at least one of these endeavors.  After 34 years as a clinician, I’ll be leaving the practice of medicine to focus on supporting other physicians.

So, each day in the office, I find myself saying goodbye to my patients.  Some I have known only a few short months.  Others I have cared for over decades.  What’s striking to me is how few people comment on the medical therapy I’ve provided.  While most are appreciative of the improvement in their venous condition, they focus instead on the personal – the trust they felt, the comfort they experienced as they discussed their true concerns, and the things we shared and learned together about life.

As Maya Angelou once said, “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”  And as Teddy Roosevelt remarked, “People don’t care how much you know until they know how much you care.”  The wisdom of these comments was certainly apparent to Rolf Benirschke and he felt it important to pass it on to these new doctors.  Throughout 30 years as a physician, they have remained important guideposts to me as well.

As physicians, it’s our job to diagnose and treat our patients.  But finding their diagnosis requires that they trust us first.  And treating them appropriately requires that we understand who they are as people.  Fortunately, patients come to our offices wanting to trust us.  They want to partner with us to obtain the best care we can offer.  What we can do is listen, show concern and compassion, and ask our own questions so we can learn what is most important to them. Only then can we most effectively use our hard-earned knowledge and experience to do what’s best for them.

 

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About Helane Fronek

Over the past 28 years I have had a fascinating and fulfilling career in medicine, initially practicing as a general internist and then as a procedural specialist, caring for patients with vein disorders. As Assistant Clinical Professor of Medicine at UC- San Diego School of Medicine, I’m thrilled to be teaching medical students crucial communication skills along with many other aspects involved in the practice of medicine.
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