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The Art Of Caring

A lot has been said lately about the need for doctors to appear more patient, compassionate, and concerned. Several studies attribute a physician's higher risk of being sued for malpractice to a lack of such attributes rather than to any failure in providing quality medical care.

Health insurers, health maintenance organizations, and patient advocacy groups have also done extensive surveys on patient satisfaction and concur with the need to encourage doctors to be "more caring."

To promote "the art of caring" a teaching scenario could be developed for physicians. Of course, both a patient advocate and an insurance company advocate should oversee the physician’s lesson which might proceed as follows.

The test begins with a patient presenting to an emergency room complaining of abdominal pain.

"How long have you had these pains?" the doctor asks.

"About three months," the patient replies.

"Three months," the insurer muses. "This is obviously not an emergent problem. They should be worked up as an outpatient. Well, go on. But retrospective review is just not gonna authorize this visit."

"And have you seen anyone else about these pains?"

The doctor continues.

"Oh, yeah," the patient replies, then adds. "Well, he was my wife's doctor. She's an interior decorator. She did his house in Southwestern and ...”

The doctor cuts him off to get back to the medical complaint.

"No, no, no!" the patient advocate admonishes. "Patients sometimes deliver a history in a more obtuse manner than a physician prefers. You'll better serve your patients if you're - more "patient."

"But remember," The insurer adds, "you have forty people to see today. And patients don't like long waits."

Continuing the exam, the diagnosis seems obvious. And the doctor scribbles a prescription.

"You're not going to run any tests?" the patient advocate says beratingly. "How do you know he doesn't have cancer? You ought to do a CAT Scan or an MRI."

"No," the insurer says, "If it doesn't get any better in another month, we can consider other testing then. You just can't shotgun expensive tests for every patient. That's why medical costs are skyrocketing."

Then, the phone rings. "It's Dr. HuYuTink," his nurse announces.

"Don't answer the phone," the patient advocate says. "Try to avoid interrupting patient care. It demonstrates a lack of concern and compassion."

"Answer the phone," the insurer advocate demands. "It's probably the HMO gatekeeper. He'll want you to transfer the patient to their primary hospital cross-town."

"It's my doctor," the doctor explains and answers the phone. "Hello, Dr. HuYuTink?"

"I'm sorry," the doctor's doctor says, "I have to cancel our session for today."

"But my nerves are getting worse."

"Just continue taking your tranquilizers. If you start to hyperventilate, rebreath in a paper bag. I'll see you next week. Goodbye."

The doctor turns to the patient advocate and the insurer and shakes his head in dismay. "My doctor," he says, “he just doesn't care."