EMBRACING THE ROLES OF MEDICINE
to achieve our best . But knowledge alone is not sufficient for a physician to perform this job well . Being a doctor is an inherently social and collaborative experience . We need the buy-in of our patients to be able to help them . Medicine is a doubles event at the minimum , and it ’ s usually a team sport .
Your teammates can help build a good foundation . Healthy relationships with colleagues and staff not only make for a good work environment , but can also help build trust with patients . The confidence that your staff places in you will tacitly – and often explicitly – be reinforced by the team in the clinical environment . A good word from a nurse or the desk staff can go to great lengths to put families at ease with a provider , especially at a critical first visit . The power dynamic is different when non-physicians demonstrate their trust in a given doc , and that can carry a lot of weight with a family . The nurses and staff at my office love kids and it shows – they set the stage for physician success from the front door through discharge . So , if you somehow missed the memo : treat your office staff and colleagues well .
Allowing humor to enter patient care is relatively rare in medicine . One of the things I love about pediatrics is the chance to let some humor show . Keeping a professional face while dealing with a ridiculous toddler is not only difficult , it is often counterproductive . A gentle joke on the fatigue of parenting shared with a new mom , making a silly face at a toddler or letting a terrible dad joke fly at a grade schooler can reduce anxiety . Making a child giggle helps most parents feel more at ease with subsequent interactions . Getting a sullen teen to crack a smile can take some effort , but it can really break down barriers . A sullen , distrustful teen is an absolute black hole of useful information . Read the room , be professional , but don ’ t be afraid to let patients laugh , and laugh with them . Shared emotions help forge trusting relationships , and laughing is a pleasant place to start .
Compassion and empathy are crucial traits both to possess and demonstrate . Working with children gives a leg up on demonstrating compassion — children are a vulnerable population , even in the most affluent and stable communities , and any parent knows that kids can be … difficult . Every medical student is a little scarred from trying to do a good ear exam on an upset toddler . Patiently demonstrating your desire to do good for a child makes building a therapeutic alliance with the family much easier . Parents want what ’ s best for the child , and knowing that you want the same thing helps bridge the gap that comes before trust . It may make disagreements between a parent and physician more difficult as well : every pediatrician has some baseline amount of paternalism in play for their patients , which can sometimes feel at odds with parental decision-making . Discussions regarding such differences of opinion , such as vaccine hesitance , are important but can be stressful .
Time is another critical factor in building trust . Fortunately , longitudinal care can afford us the time to develop the trust needed for a therapeutic relationship . Pediatricians are gifted with an opportunity for true continuity , sometimes from birth . Being alongside your patient and their parents , watching them grow , develop and encounter challenges grants a unique perspective . Kids and parents alike learn to trust pediatricians one visit at a time .
Finally , good communication may be the single greatest key to building trusting relationships among physicians , patients and their families . It is rare to be able to show collegiality , humor or compassion through action alone . We have to listen , clarify and educate . In pediatrics , there are often additional challenges . We need both caregivers and patients to contribute to our understanding of the clinical situation . We also need them to understand our concerns and plan of action ; but we must recognize the difference in comprehension between the parent and the child . Pediatricians have to tailor histories and plans across a wide range of developmental stages and educational backgrounds , sometimes serving multiple parties in a single visit . Doing this efficiently and effectively is a constant challenge . But given that “ doctor ” originally meant “ teacher ,” it ’ s what we need to do , and as pediatricians , we get a lot of opportunities to practice .
So , getting to the “ right answer ” in pediatrics , and in medicine , is not just having knowledge or skills . Rather , it is a synthesis of hard knowledge coupled with the softer elements of emotional intelligence , communication skills and relationship building . Each element contributes to the trust at the heart of effective therapeutic relationships . So , no problem ! Fortunately , as a pediatrician I may have 18 years or so with my patients to get it right .
And for those wondering – my PICU patient got his trach . But it was capped about a week later .
Dr . Meyer is an Assistant Professor of Pediatrics , University of Louisville and practices with Norton Children ’ s Medical Group Stonestreet .
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