Health care providers must maintain their objectivity
when discussing a patient’s health and treatment options. However, most
providers have their own personal experiences with trauma, disease or loss. Is
it appropriate for a practitioner to share their own personal experiences with
their patient? Kenneth Miller, MD, of the Dana Farber Cancer Institute,
discussed with O&P Business News how the experiences carried
by the clinician can contribute to more compassionate care for the patient.
“We all have our experiences,” Miller said.
“Patients carry their previous experiences and clinicians carry their own.
[Clinicians] can not forget about their own personal experiences, they can use
them. At times, I will share that with families. I will say I have been in your
situation and people do get better.”
Miller has been an oncologist for 20 years. Twelve years
ago, his wife Joan was diagnosed with leukemia.
“One thing about illnesses is how fast it
happens,” he recalled. “You are minding your business one day, there
is a sunset and a sunrise and suddenly you have big problems and everything
changes. The realization sets in of how fragile we are.”
Miller explained that doctors or anyone associated with
the health care industry, are no different than their patients. Everyone has
baggage or luggage, as Miller called it. Despite the negative connotation, the
luggage we carry or associate with health and illness can be good or bad.
Miller recalled an instance when his daughter was scheduled for major brain
surgery.
“The day of surgery, the surgeon came in and said,
‘The computerized axial tomography (CAT) scan is better than expected. I
do not think we need to do this,’” Miller explained. “The point
I am trying to make is when Joan got sick, I kept waiting for someone to come
in and say, ‘we don’t need to do this.’ Doctors are no different
than the patients.”
Many O&P practitioners are also amputees. For a new
amputee, knowing your practitioner will relate to and understand your anxieties
can be a calming or even uplifting experience.
“Something more visible like a prosthesis is
powerful for the patient to see,” Miller explained. “When
appropriate, I think sharing that people do go on to live productive and happy
lives is powerful.”
However, there is a delicate line that practitioners
must not cross. Clinicians should avoid using the patient as their own personal
form of therapy. On the other hand, sharing positive outcomes and positive
personal experiences related to the health issue can be inspirational.
“One of my take home messages is that hope is free
and does not have a lot of side effects,” Miller said. “Hope is
different than lying to people. You have to be responsible. But I think hope is
a powerful thing.”
Miller noted that there are often multiple experiences
occurring at the same time by different people in the doctor’s office or
hospital room.
“All within one small room there are these
different emotions,” Miller described.
During his wife’s treatment and recovery, Miller
observed the many benefits of the health care team — from the surgeon to
the social worker to even the snack lady. Each member provided his or her own
personal treatment.
“The snack lady was a loud woman but she was
funny,” Miller said. “She came by twice a day and made us laugh. The
most obvious person is the surgeon or cancer specialist, but sometimes the
other people around can have a pretty profound effect as well.”
Miller is currently recovering from heart bypass surgery
and has experienced firsthand the powerful and reassuring connection the doctor
can have with his or her patient.
“In a sense, there is something comforting in
turning over one’s life to people you trust,” he said. “Even
though they are doctors that I had just met, they were smart and focused and I
had a sense they were watching out for me. Throughout our lives we like to
exercise our independence, but even the act of going in for surgery is
profoundly trustworthy.”
Along those same lines, it is important for
practitioners to consider their bedside manner when working with patients.
Miller noted that patients are not statistics and practitioners may lose sight
of the human element that is crucial to treating a disease. Even the smallest
act of generosity or compassion can have a large impact on the patient.
“It is not just the scalpel or the medication or the device that
contribute to recovery, it is also the practitioner’s warmth and kindness
toward the patient,” Miller said. “It is impossible to overdose on
graciousness.” — by Anthony Calabro
I make no effort to hide my amputations from my
patients, but I also do not provide that information freely. Each
individual’s experience of disability and healing is unique. I believe
that clinicians who have such experiences need to be careful about how and when
they share those experiences with their patients. As a congenital amputee, I
have no idea what it feels like to wake up in a hospital bed with a missing
limb or to suffer a stroke.
Some patients will suddenly put a lot more trust in my
judgment as a clinician after they discover that I am an amputee. This can
shift the power balance of the relationship and it is extremely important not
to abuse that trust. After all, the fact that I am an amputee is only one small
aspect of who I am and it does not imply that I am a more skilled clinician.
However, the shared experience that I have with my
patients of attaching a machine to my body every morning has allowed me to
assist them with figuring out tasks that most able-bodied people take for
granted. This would include navigating airport security or getting out of a
swimming pool without making oneself a spectacle.
— Jason Wening, MS, CPO
Clinical research
director, Scheck and Siress