I just finished reading a book by Dr. Jerome Groopman and his wife, Dr. Pamela Hartzband. The book is titled, Your Medical Mind. I would recommend the book if you are wanting to understand how and why you (or someone close to you) make the medical decisions you do.
Dr. Groopman/Hartzband review the various decisions that patients make and what makes them decide on a particular course of action. They review the four basic options of medical decision making, believers, doubters, minimalist (what they also called the naturalist view) and maximalist. In the book they interview several patients and delve into what made that patient either a minimalist, maximalist, etc.
The two physicians also interview patients about what happened after they made their decisions regarding surgical options, taking medications, etc. They asked them whether they had any regrets, would they have changed their minds?
This book was an interesting read for me because it showed that for some patients their medical decisions regarding their own healthcare is a fluid one, one day they can say ‘this is what they want,’ another month down the road their decision has changed and they want something else. Just as patients do not stay stationary in time, nor does medicine.
Things change with patients, family scenarios change with patients, financial situations change with patients. As patients change, so does medicine. Not only are their new treatments available, but patient-physician relationships change (hopefully becoming clearer with the physician acquiring a more focused understanding of what motivates the patient to work towards their own better health).
Medicine will remain an art. It is an art (using wisdom, understanding, compassion) on the part of the physician or clinician as they see each patient. Yes, we as clinicians learn the science of medicine (or what is also called ‘evidence based medicine) during our training days going through our PA programs or medical school. But then we spent the rest of our working days seeing patients and learning how to apply the ‘art of medicine’ to each and every patient we see.
A part of our applying the ‘art of medicine’ is learning what motivates patients to make the medical decisions they do. Then it is up to us to help them make the most of that decision and achieve the best healthcare they can.
I have spent years working alongside numerous physician mentors. I have learned an incredible amount of wisdom, undersanding and compassion from them. I remember one physician mentor who had been my opthalmologist as I grew up. He told me ‘ask, ask, ask again until you understand everything you need to know. Don’t be afraid to ask.’ And with that sage advice I left to drive south to Texas to begin my PA training. I’ve never forgotten what he said, as I’ve applied it numerous times during my working in medicine.
I am honored to work in medicine, honored that patients trust me, confide in me and believe in my capabilities as a medical provider. I will never stop growing and learning medicine. I’m challenged by it every day.