The doctor looks at the patient who
Sits restlessly, coughs and is not smiling
The doctor's first thought
"Why is this patient coughing?"
Instead of
"This patient appears uncomfortable,
What can I do or say to relieve the discomfort?"
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What I have just described is a simple example of the professional behavior or perhaps misbehavior of maintaining "clinical distance". It is the mindset of a technician to immediately look at the anatomy and pathology of the patient's symptoms rather than to look at the patient. Shouldn't the doctor's first interest be the observation and consideration of the patient as a whole human person who comes for consultation because of a personal problem and attempt to understand how the patient is feeling? But the fear of being contaminated by the patient's "feeling" may be more in the mind of the doctor than being exposed to whatever bacteria or viruses the patient is bearing and has become the basis for maintaining "clinical distance"; not measured in meters but in pain, in sorrow, in anxiety and fear.
But, shouldn't, at first, the doctor be more than a technician in the diagnosis and treatment of illness? Shouldn't the doctor at first find and express some signs and acts of partnership with the patient's worries with responses of sympathy ("I care") and/or empathy ("I understand")?
In the current rush of medical practice where time is limited to attend to each patient and the fear by doctors of "becoming too emotionally involved" (contaminated), it is considered a wise practice to maintain that "clinical distance". But is "clinical distance" really what makes a good medical professional? Does it provide a way to maintain physicians in less emotional distress, fatigue and more time to diagnose and treat and thus is of benefit and value to the patient?
On the other hand, maybe it is the basis of why some patients are dissatisfied with their doctors in many ways. Perhaps, we medical school teachers should more strongly emphasize to the students something more than the creation of a differential diagnosis list as the doctor-patient relationship begins and strive to shorten that "clinical distance".
What is your opinion about maintaining vs shortening "clinical distance"? Should the following be the doctor's first thought?
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The doctor looks at the patient who
Sits restlessly, coughs and is not smiling
The doctor's first thought
"This patient appears uncomfortable,
What can I do or say to relieve the discomfort?"
..Maurice.
