I had a WOW experience yesterday when I accompanied my wife to interview a new doctor for her. As some reader may know she is being seen by specialists At MD Anderson Medical Center in Houston for Stage IV lung cancer. She has not had a local oncologist for the past 6 years…but she does now. And we both love this guy!
You need to understand that I have been very underwhelmed by the local oncologists I had met up till now. I am sure they were clinically proficient…but as a group not a one could muster a smile….or any sense of interest or curiosity in my wife’s medical condition. I held out little hope that this new doctor would be any different.
After being ushered into the exam room, a Physician’s Assistant came into the room to get smart about my wife’s history and records (which she brought). Three things surprised me about the PA. 1) She was incredibly thorough actually reading the radiology reports and reflecting with my wife on what she learned, 2) her empathy – as she read the reports she actually used terms like “bummer” when she read how my wife developed pneumonia during her treatment, and 3) she faithfully summarized the results of her review to the doctor before he came in. In other words – the PA listened and heard what my wife shared with her!
Now enters the doctor. He has a warm smile on his face while he extends a hand to my wife and me. He says just enough for us to know that he has talked to the PA. He asks my wife to sit on the exam table and does a physical exam (also a rare event these days).
He then got her down from the exam table into a chair and sat down himself facing us. He asked my wife why she was there and what she wanted to accomplish. After all she had world class docs back in Houston. He asked her why she thought her docs in Texas had stopped her oral chemo for 3 months. He asked why they suggested she start some of her care locally instead of continuing to go down to Texas. If the point isn’t obvious…the doctor seemed to value her opinion of what was going on with her care.
He empathized about it is like to be treated in a world class academic medical center….often long on experience but sometimes short on bedside manner. He volunteered that given my wife’s situation he saw his role as collaborator with her primary cancer care team in Houston. He would take care of her needs locally and advocate on her behalf when needed with the “experts” at MD Anderson. And I was worried that this guy’s nose would be out of joint given her continued relationship with her docs in Houston. The visit ended with a hug between my wife and her new doctor. Something my wife told the doctor she was used to from one of her Houston docs.
What we like about my wife’s new doctor is his “mindfulness.”
Specifically we liked the doctor’s attentiveness, curiosity, flexibility, and presence – all qualities of mindfulness according to note researcher Ronald Epstein, PhD.
We have already established the doctor’s attentiveness to the details of my wife condition. His curiosity was evident by his questioning of my wife’s opinions on how her case was being managed. In addition, the doctor enjoyed working with lung cancer patients. The doctor flexibility was evident from his willingness to play “second fiddle” to my wife’s doctors in Houston. Finally this doctor was “present” at all times during her visit. He listened, picked up on “cues” from my wife and I, anticipated my wife’s needs and never looked at his watch.
So the next time you visit your doctor…or you visit with a patient, you might think about “mindfulness.”
It doesn’t take any more time I suspect…but can make all the difference to patients and their caregivers. Heck I was so impressed that I wrote a blog posting about it!
Epstein RM. Making communication research matter : What do patients notice , what do patients want , and what do patients need ? Journal of General Internal Medicine. 2006;60:272-278.