Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

A large part of healing is listening, caring, and imparting hope

Afshine Ash Emrani, MD
Physician
January 5, 2014
Share
Tweet
Share

As the year comes to a close, we physicians feel tremendous uncertainty with the rain of change from Washington. As I approach my third decade of medical practice, I feel more distant from the patient who desperately seeks my attention. I struggle daily to reconnect with her, recalling the fading reasons I embarked on this field, trying to resuscitate the patient-physician relationship which is central to our broken medical system.

Often when my faith in this sacred profession was near broken, an unlikely patient with a bizarre illness that peaked my curiosity and passion, sat me down, thanked me for saving his life, and set on fire the torch which once burned bright and was otherwise dimmed by the smoke of coding, regulations, supervising entities, and rude patients.

When I first stepped onto the clinical wards, an astute teacher taught me a profound lesson: “Learn to listen to the patient. They come with the answer. They will let you know what’s wrong but you have to pay attention.”

“Rick,” a 93-year-old real estate tycoon has been in my current practice for fifty two years. I have taken care of him only for the last eight. “If I could tell my grandchildren to do one thing with their life, it would be to go into medicine to heal people. We have plenty of people who make money, many businessmen, but not enough healers. When I was younger, I admired money, but now that I am older and sick, I respect healers.”

Really? I am surrounded by those who find my earnings laughable when they account for the number of hours I put into my work, the years of training and assumed loans, the liabilities, the troubles of running a small business. But despite the tremendous focus on money, something in Rick’s message rings true. This is the kind of truth that I once knew and forgot.

We physicians know too well how fragile life is, how each cell that divides has the potential to turn into cancer, how young lives are cut short by accidents, by depression, by disease. In the past few years, I have lost several colleagues to sudden cardiac death, pancreatic cancer, suicide by gun, all within a few years of my age.

To be sure there is much to be improved in our field. What should be holy and intimate has been replaced by bureaucracy, documentation and guidelines. Checking boxes. Much of what we document is not to benefit the patient but to get paid for the procedures we deem necessary.

We struggle to establish long-term relationships needed to influence patients, to keep them healthy throughout diet, exercise and preventive measures. But today, in the era of electronic health records, the laptops get 90% of our attention. The eye to eye contact is lost. Regulations set patients against doctors. For example, if a patient complains of chest pain, I, the cardiologist am forced to perform a stress test. For this test to be reimbursed, a rule-out diagnosis is not accepted, and the diagnosis of coronary artery disease must be used, even though in the end, it is found that the patient was suffering from reflux and anxiety, no heart issues unveiled. If this patient applies for life insurance, he will be turned down because of the diagnosis of coronary artery disease used for billing. The patient is understandably irate.

Many fields of medicine no longer accept insurance, highest amongst them, psychiatry. In the past few years, I have found myself in the odd position of treating more depression and anxiety for the shared symptoms of chest pain, shortness of breath, palpitations. Within my exam rooms there is an outbreak of overwhelming misery. There is the perfect storm of disintegrating relationships, financial hardship, and above all, loneliness. Many cannot cope and express near suicidal thoughts. In the elderly, there is a huge lack of family support, loneliness being their greatest disease.

We are at the forefront of a major change in the health care system and are experiencing growing pains. We are also living a dichotomy where technology is rapidly improving our diagnosis and treatment, but finances are not allowing their use. We are treating an aging population, routinely caring for complicated patients that have coexisting multi-organ failure. We juggle increasing number of medications with side effects and interactions to treat chronic conditions with no prospect of cure.

To my colleagues, I say, do not give up! Rather find the initial reasons you took upon yourself to be the healing partner of your patients. Do not forget that patients are suffering and are looking to us to be healed. A large part of healing is listening, caring, and imparting hope. I dare say that if most of us were independently wealthy with no need for money, we would continue to take care of the ill. One day, sooner or later, you too will be a patient. Your frustrations with uncertainty should not add to the illness of your patients. Medicine is unparalleled in its intellectual scientific quest balanced with the privilege of intimate involvement in patients’ lives.

To my patients, I say, do not be angry. Your doctor is not God. Your doctor may also be ill, just like you taking medications, just like you suffering from anxiety, just like you struggling with finances. Be kind, for doctors do more for patients they love. Show respect and you will receive more attention. Ask questions and use your doctor as your partner on the road to health.

To students of medicine, I say, you are amongst the most selfless, dedicated and hardworking elite. A country can only be as good as its students, its future teachers, its healers. You give up much. When your friends are playing, you are studying. When they are earning money in businesses, you are accumulating loans. When they are forming families, you are entering residencies and fellowships. Do not give up your passion for healing as life is not about winning financially but doing something important, something that goes beyond you.

ADVERTISEMENT

Finally, to the nation, I say this land still remains the beacon of hope for the world. We misuse the terms “terrible” and “catastrophic” for political wins. We must step back and realize that what is truly catastrophic is a natural disaster such as occurred in the Philippines, and what is truly terrible is a child dying of hunger and of poor sanitation. We are merely facing the growing pains of a nation that remains the land of opportunity for both patients and physicians alike and shelters with open arms refugees of political uproars from all over the world. Challenges always usher in opportunities. When Medicare was introduced, there were tremendous difficulties and opposition. In the end, the USA will come out stronger, but what must not be broken is the patient-physician relationship.

Afshine Ash Emrani is a cardiologist and can be reached at Los Angeles Heart Specialists.

Prev

A call to retract the JNC-8 hypertension guidelines

January 4, 2014 Kevin 5
…
Next

Doctors cannot predict when the end of life truly comes

January 5, 2014 Kevin 5
…

Tagged as: Cardiology, Primary Care

Post navigation

< Previous Post
A call to retract the JNC-8 hypertension guidelines
Next Post >
Doctors cannot predict when the end of life truly comes

ADVERTISEMENT

More by Afshine Ash Emrani, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Is it ever appropriate for us to choose the timing of our death?

    Afshine Ash Emrani, MD
  • Medical lessons from Robin Williams

    Afshine Ash Emrani, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Vitamins are not magic. We need good science and better sense.

    Afshine Ash Emrani, MD

More in Physician

  • The shocking risk every smart student faces when applying to medical school

    Curtis G. Graham, MD
  • The physician who turned burnout into a mission for change

    Jessie Mahoney, MD
  • Time theft: the unseen harm of abusive oversight

    Kayvan Haddadan, MD
  • Why more doctors are leaving clinical practice and how it helps health care

    Arlen Meyers, MD, MBA
  • Harassment and overreach are driving physicians to quit

    Olumuyiwa Bamgbade, MD
  • Why starting with why can transform your medical practice

    Neil Baum, MD
  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...