Medical students learn to build a patient's trust. But how often does that really happen?
We need to show health-care users that their voices matter
This column is an opinion by Leah Sarah Peer, a medical student in Montreal. For more information about CBC's Opinion section, please see the FAQ.
Navigating the health-care system was not new to me. But waiting with my sister for more than 14 hours before seeing an emergency physician who refused to listen was.
When he brusquely entered, he glanced at a medical resident's notes, observed my sister's scalp and found the location of the pain that was keeping her up at night.
He placed his fingers on the area and pressed down to assess for pus or an infection. I saw her wince with pain — but I also saw she didn't trust the doctor enough to say anything.
I was furious. This physician's approach did not match the clinical bedside skills I was learning in medical school. We were lectured on the importance of devoting full attention to the patient, to ensure that we do not miss out on signs and symptoms for a potential diagnosis.
As a future physician, I know it is my duty to be a patient's advocate and support them, even when I don't immediately know how to treat them. I'm committed to seeing my patients as people, not just diagnoses.
But in this triage room in Montreal last fall, it felt like we were wasting a doctor's time.
When I tried to open up conversation, to articulate possibilities and to understand the doctor's style of thinking and reasoning, I was ignored. My sister was sent home, and told to come back to the emergency room if her symptoms changed.
The system we both had faith in failed my sister. What she felt was a serious issue was dismissed as nothing.
Perhaps more opportunities for patients to share their stories, and research that is driven by patients' lived experience, will contribute to meaningful change and enhance the clinical relationship. But physicians must also be open to a collaborative model of care by listening to the patient in front of them and trusting that they are the experts of their own bodies.
This collaborative model includes working with other members of the health-care team, so that specialists can come together to better discuss a patient's case.
As health-care delivery becomes more complex — through implementing new technology and increasingly specialized doctors who depend on each other — physicians will have to adapt.
That adaption must also include creating health spaces that are safe, inclusive, anti-oppressive and anti-racist to facilitate dialogue, trust and connection. This will improve outcomes, safety and quality care for diverse patient populations.
I realize now that every interaction with a patient has an impact on their decisions and relationship with the health-care system. I see it in the fear my sister now has when she visits the hospital. Medicine is a profession of continuous learning; this process does not stop once you have your medical degree. It is a journey of discovery that I'll embark on with each patient, bringing compassion and science together, to serve them.
If health spaces aren't safe, and instead further aggravate harm as a result of systematic racism in health care, a lack of inclusive care or a lack of knowledge of care for those of colour, there is a lot of work that must be done. And if a physician's behaviour is a consequence of burnout or stress given the shortage of staff — shouldn't we address that immediately?
No excuse justifies inadequate care nor the dismissal, misdiagnoses and potentially life-threatening consequences that can come as a result of disinterested, prejudiced physicians.
In an overburdened health-care system such as ours, showing compassion and listening to the patient in front of you can still go a long way.
My sister's experience is one that is far too common. It is time we do better. Quality health care begins from the minute a patient enters a clinic or hospital as they are truly at the heart of medicine.
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