Articolo di Wolfgang Gilliar su StatNews

This story illustrates a broader crisis in medical education. Today, most schools myopically focus on turning out technicians. Through textbooks, lab experiments, and lectures, budding doctors learn the hard science of medicine. They memorize body parts, processes, and conditions, then dutifully demonstrate their knowledge in high-stake examinations.

This purely technical approach can obscure the human side of medicine and erode empathy — the ability to understand and care about what makes a patient tick. In fact, the empathy levels of medical students actually decline as they progress through school. Many become emotionally disengaged from the people they’re caring for — and that disconnect can impair care.

Forging a strong emotional connection with a patient can be just as important to the healing process as prescribing the right drugs or performing the right surgery. A 2012 study published in the journal Academic Medicine found that the rates of serious complications among diabetic patients were almost 50 percent lower among those whose doctors had high empathy levels compared to those whose doctors had low levels. Improving physician empathy has been shown to help overweight individuals with diabetes drop more weight, arthritis patients experience less joint pain, and those with high blood pressure reduce it.

A 2014 study published in the journal PLoS One examined a baker’s dozen of clinical trials in which doctors were taught empathy-building techniques, even simple ones such as making regular eye contact. Their patients fared significantly better than doctors who didn’t receive such training. continua a leggere

Are you “battling” heart disease”? Have you “beaten” cancer? Are you “fighting”a chronic illness?

Articolo di Carolyn Thomas su MyHeartSisters.org

These wartime references are metaphors as described by Dr. Jack Coulehan, a physician, an award-winning poet, and editor of the 5th edition of The Medical Interview: Mastering Skills for Clinical Practice, a best-selling textbook on the doctor-patient relationship. Dr. C explains that there are several basic metaphors used in medicine that to a large extent generate the vocabulary of doctor-patient communication – but can also unintentionally objectify and dehumanize the patient.

Here are three of the most prominent metaphors you’re likely to encounter in health care:

Parental (paternalistic) metaphor

Disease is a threat or danger  (“She’s too sick to know the truth”)

Physician is a loving parent/ patient is a child  (“We don’t want him to lose hope”)

Engineering metaphor

Disease is malfunction   (“He’s in for a tune-up”)

Physician is an engineer or technician  (“Something’s wrong, doc – you fix it”)

Patient is a machine  (“We need to ream out your plumbing”)

War metaphor

Disease is the enemy  (“I treat all my patients aggressively”)

Physician is a warrior captain  (“She’s a good fighter”)

Patient is a battleground  (“The war on cancer”)

Dr. Coulehan believes that contemporary medicine has now largely abandoned the parental (or paternalistic) metaphor, perhaps the most prevalent way of thinking about the patient-physician relationship in the good old days.

But try breaking that news to the Emergency Department physician who misdiagnosed me despite my textbook heart attack symptoms in 2008, and – just as alarming! – the ER nurse who returned to my bedside and sternly warned me after the doc had left my cubicle:

“You’ll have to stop questioning the doctor. He is a very good doctor and he does not like to be questioned.” continua a leggere