My Meandering Mind
An Op-Ed by Carol Purroy
Healthcare in the 21st century sure is different from what I grew up with — in the not-so-long-ago 20th century. I’m not talking about ObamaCare. And I’m not talking about all the awesome miraculous advances in medical science and technology. What I’m addressing here is something more alarming: the very definitions of “healthcare” and “doctor” seem to have changed.
In my younger days, “healthcare” meant the practice of caring for patients. The second half of that word — care — was important, as in TLC (tender loving care). Healthcare has now, all too often, come to mean the mechanics of medicine.
In the past, a “doctor” was a licensed physician who was caring, compassionate, sympathetic, and understanding. A doctor inspired trust and listened to his patients’ innermost doubts, fears and secrets, while tending to their medical needs.
Back in the day, we had one doctor — the family doctor — who treated nearly every disease or condition known to medical science. It was only if we had an extremely rare condition that a family doctor might suggest a specialist. (Ours never did.)
Doctors used to have something called “bedside manner”. When we saw a doctor, he or she looked us in the eye and touched our hand or shoulder; engaged us in conversation while conducting the physical exam, expressing concern and engendering confidence as medications and advice were dispensed.
I bring this up because I recently signed on with a physician, after not having had one for nearly 30 years. (I’m so healthy I haven’t bothered with doctors.) My, how things have changed in the field of healthcare. I admit I was shocked.
Healthcare in the 21st Century
When my new doctor,– a woman in her early-to-mid 40s — whom I had not yet met, walked into the room, there was no “Hello, I’m Dr. So-n-so,” no handshake. No eye contact, no “How can I help you?” or even “Why are you here?” No nothing.
In her hands was a laptop computer. She set it on a desk against the wall (6′ from me), sat down before it and, never taking her eyes from its screen, fired off questions (which I’d already answered on the intake form) and typed my responses.
- “Father’s age when he died?”
- “Cause of death?”
- “Mother’s age when she died?”
- “Cause of death?”
- “Any siblings?”
- “How would you describe their health?” And so on.
Prior to the doctor’s appearance in the examining room, a Nurse Practitioner had taken my blood pressure, run a space-age thermometer across my brow, and stuck a plastic clothespin-like thing on my finger, then handed me an open-back garment. “Take your clothes off and put this on.”
When the time came for Dr. So-n-so to listen to my lungs, she did, with no apparent inkling that there was an actual person at the business end of her stethoscope. She then did a perfunctory breast exam, seemingly unaware that said breasts were attached to a living, breathing woman. The same level of detachment applied as she peered up my nose and into my ears. I could’ve been a cadaver for all she cared. That was the extent of the physical exam. Cursory. I guess that’s all that’s required of a physical exam in healthcare in the 21st century.
She snapped her computer shut, stuck it under her arm, and left, without a goodbye, without a hint of pleasantry. Were we done? Should I wait and see if she comes back, or get dressed and leave? When she didn’t return, I dressed, stopped by the desk to pay my bill, and went home. I got the feeling that if we met in the hall, my Primary Care Physician would not recognize me or perceive that we’d just had an intimate encounter — you know, me naked; her hands on my flesh.
Primary Care Physician
The Family Doctor of old, who dealt with anything and everything, has been replaced by the Primary Care Physician, who, so far as I can tell, deals with nothing. The operative word in the title is primary, meaning “first” or “initial.”
Funny, I thought “primary” meant “chief,” “dominant,” “main,” or “central” (Roget’s 21st Century Thesaurus), but that’s the alternate definition.
It seems to me that today’s Primary Care Physician is the funnel through which you must pass to get to doctors who can do something. A gate-keeper. In healthcare in the 21st-century, a Primary Care Physician is a “referral agent.” On a follow-up visit, after sending me to a bunch of specialists for multiple, varied tests, most of which had nothing to do with my symptoms, she did make a diagnosis, based on the other doctors’ findings. Then she sent me to yet another specialist who instructed me about prevention.
No Doctor-Patient Relationship
When I told friends about my disturbing exchange with my new doctor, several said they’d had the exact same experience.
“So far as my doctor is concerned, I could be a life-sized Raggedy Ann doll.”
“There is no doctor-patient relationship anymore. That’s gone by the wayside.”
“My doctor’s only ‘relationship’ is with her computer.”
“My old doctor made me feel important; like a friend. Doctors don’t do that anymore.”
“Yeah, they act like they just want to get you out of there, in a hurry. They act like they don’t want to know you.”
Bedside Manner 101
Here’s my point: These doctors grew up in the age of computers and video games and smart phones. Like many in their generation, they never learned how to relate to people. This is such a pervasive problem that many corporations require their employees to take a Dale Carnegie-type of course that teaches them simple things like making eye contact and smiling, and provides basic phrases, such as, “Hello, I’m Joe.” “Nice to meet you.” You know, real tough stuff.
What used to be referred to as “bedside manner” is plain old common courtesy — like acknowledging the other person’s existence — and showing that you care about him or her. What (it seems) many of today’s doctors don’t get is that healthcare is about more than just technology and science. It’s also about inspiring confidence and trust. That’s what it means to be a Healer.
For healthcare in the 21st century, I’d like to suggest a required course: “Bedside Manner 101.” Medical students would have to take it and demonstrate that they “got it” before they can put M.D. after their names. And for doctors who got out of medical school and through internships and residencies without people skills, there would be “Remedial Bedside Manner,” also required.
Computers are a fact of life for healthcare in the 21st century, and they do make for more efficient record-keeping, etc., so I don’t object to them, per se. But they shouldn’t be allowed to take the place of the time-honored … and crucial … doctor-patient relationship.
21st Century Affliction
Obviously, it’s not only doctors who have this 21st Century affliction. In my opinion, we ought to start teaching kids at home and at school, how to connect with other people. Every family should have “electronics-free” time, in which all such devices are banned. This should include every mealtime. The art of conversation is a family value…and a societal value. It’s not just about How to Win Friends and Influence People, it’s about how to be human.
Disclaimer: I know that not all doctors fit this description. And now, after taking myself off “Dr. So-n-so’s” patient roster, I’ve found one who will be my healthcare in the 21st century provider. He does have a good bedside manner; I’ll accept nothing less.
What has been your experience with Healthcare in the 21st century? Please comment in the form below.
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