FEATURE
we forget we are caring for human beings with needs beyond their medications , surgeries , tests and their multitude of forms . Humanism often gets swept under the rug in favor of the never-ending push to “ move the meat .” I recently read an article written by Dr . Boris Veysman in the Annals of Emergency Medicine on the topic of “ moving the meat .” Dr . Veysman expressed his utter frustration regarding our health care system ’ s value on efficiency over the integrity of medical care . He related that he saw “ moving the meat ” in action first hand when an extremely busy emergency medicine resident missed acute glaucoma in his own grandmother . In the closing line of his article , he asserted that “ If you ’ re movin ’ meat , you may be a butcher . Real emergency physicians thoughtfully care for patients .” I agree with Dr . Veysman and think the push for efficiency and speed in our health care system has the potential to harm patients in many ways , from doctors missing a life- or limb-threatening diagnosis to subtler errors , omissions and emotional tolls on both patients and doctors .
One of the things I find most frustrating about modern medicine is the very unequal ratio of time spent doing administrative work / computer tasks / documentation to quality time at the bedside with patients . Speed and efficiency reign sovereign in our current system , and it has become very difficult for physicians to thoughtfully consider each patient ’ s case , much less spend meaningful time at every patient ’ s bedside — at least not without feeling rushed or distracted . After all , how could we possibly have time to do this when we are seeing 20 + patients per day as a primary care physician , caring for 30 + patients in a 12-hour emergency department shift , or rounding on 20 + patients per day on a hospital service ? Caring for high volumes of patients in an age where documentation requirements and administrative tasks have exploded is not in the best interest of our patients or physicians . It places patients at a higher risk for becoming victim to medical errors or omissions , and markedly predisposes doctors to burnout . Moreover , if we become stuck on speed , we risk neglecting the human side of medicine , the part that prompted us to pursue this profession in the first place .
Recently I was reminded that sometimes we must put aside our sundry doctoring tasks ( they will never go away ) and focus on the fundamentals of medicine . I was working ICU night shifts last winter , working with an emergency medicine intern who earned my highest respect . One of our patients became extraordinarily ill , and despite the best efforts of multiple nurses and physicians , this patient died . Emergency medicine doctors are often stereotyped as the crazy yet stoic cowpokes of medicine , but this intern no doubt crushed that stereotype . It was his idea to stay behind after the patient ’ s death , and together with the patient ’ s nurse and myself , we bathed the patient and changed his blood-stained clothing before his family arrived to see him . We gave dignity to this patient , even in death , and that matters more than any documentation in the EHR or administrative task we will ever complete . We were doctors for this patient to the very end , and I will never forget that intern ’ s sense of responsibility and loyalty to this patient even in death . He truly was placing humanism above all else . I loved being witness to that .
It bothers me that some people stereotype us as being “ holier than thou .” I know doctors are inherently good people with good intentions . Not long ago , I walked into the patient ’ s room , where the stench of fresh stool hit me like a bag of bricks . This was a true “ code brown .” The nurse was struggling to move the patient without making a bigger mess , and so I helped them out in this tricky situation . The next day , I went back and heard that several nurses were talking about me ; apparently , they were impressed that I had helped . When I asked why , they told me that most doctors would run the other way and never dream of helping out in such a situation . They told me to never change , as it was refreshing to see . Doctors , I want this stereotype to go away . If one of our health care colleagues needs help caring for a patient in any capacity ( especially when there is no one else around to help ), it is our responsibility to help for the sake of the patient , not to let hubris and / or our preoccupation with our mountain of duties get the best of us . These negative perceptions of doctors will persist until we all show that we are on the same team .
I can ’ t begin to fathom what it will take to fix our broken health care system . It is vital for us to engage in health advocacy to enact positive change at national , state and local levels . Beyond that , there ’ s so much we can do on an individual level to promote humanism in medicine , despite all the annoyances we must deal with in our jobs . We are not just cogs on the machine of our broken system , we are not workers on a factory line . Rather , we are healers , listeners , innovators , scientists , caretakers and team players who individually and collectively have so much to offer to humanity if we put our minds to it .
Doctors , take extra minutes to listen to your patient , and do it at eye level without your hand on the door knob . Hug someone who needs it . Bring your patient a pitcher of water . Sit in silence with a grieving family . If your patient with metastatic cancer is hankering for a piece of chocolate , go find her some . Bring your sick patient ’ s husband a cup of hot coffee . Basically , be like my grandma and make your patients and colleagues feel valued and loved even when the system we work in feels hopelessly dysfunctional .
These are the things that differentiate the good doctors from the great doctors – be a great one . If you don ’ t , Loretta Louise Pilson , my feisty German grandma who promised to haunt me if I misbehaved , will haunt you !
Reference Veysman , B . D . Butchers Move The Meat ; Doctors Care for Patients . ( 2010 ). Annals of Emergency Medicine , 56 ( 5 ), 578-579 .
Suzanne McGee , MD , is the Chief Medical Resident for the UofL Internal Medicine Program .
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