Connecting with another human being in a meaningful way allows a physician to practice the art and the science of medicine. Showing you care helps to gain trust, and helping to alleviate pain and suffering establishes a bond. When you give of yourself on behalf of your patient, as a caregiver you share something not many people get to experience—compassion-driven skill. Choosing a career in health care is most often motivated by a desire to help make other lives better. How we go about our work conveys to patients, who may feel vulnerable and fearful of the unknown, that we have their back.
Consider the four pillars of emotional intelligence and their application to caregiving. Self-awareness allows caregivers to understand the parameters of the encounter. For example, after obtaining a tearful history from a patient, my office tech would leave me a sticky note on the patient’s chart alerting me that the patient had just lost a spouse. It prepared me for the grief-struck patient, and I offered my sincere sympathy. However, I would gently move the discussion from personal loss to the reason for the appointment, saying, “But now it’s time to think about you.” Social awareness is demonstrated by picking up on body language. When I was running late in the office, my staff warned patients that I would be in shortly. Once, when I opened the exam room door and apologized for being late, one woman raised her arm and pointed to her wristwatch while shaking her head. I recall asking my scribe to “kindly take the knife out of my back.” My comment broke the tension, and we shared a laugh before moving on to the exam. You could argue that my comment was a form of self-management whereby I admitted fault and asked for forgiveness. Relationship management required that I make a note in the chart to schedule that patient early in my appointments to avoid another embarrassment. Not every relationship with a patient is long-term. No-shows were given the benefit of the doubt, and a follow-up call was made by my staff. A second no-show prompted a letter by certified mail asking the patient to reschedule an appointment, especially for a sight-threatening condition like glaucoma. A copy of the letter was included in the patient’s chart.
Caregiving can be both rewarding and emotionally taxing. Doctors may feel compromised in their work due to serving the needs of their bosses’ needs instead of serving their patients’ needs. When their autonomy for decision-making is subject to second-guessing by health insurance companies or corporate administrators, doctors may become frustrated. Forcing doctors to substitute corporate goals and metrics for physicians’ priorities for patients may lead to moral injury and burnout. Giving doctors the authority to treat their patients without struggling for permission from third parties is what physicians and patients deserve but rarely experience in today’s health care system.
Changing that system begins with respecting the bond between a patient and a physician. That bond is the fundamental building block for change, for developing a new model of health care where doctors and nurses are both intellectually and emotionally equipped to do what they do best—take great care of patients—with the least amount of administrative burden.
Paul Pender practiced clinical ophthalmology for 38 years, specializing in the medical and surgical treatment of eye diseases. He completed his residency at the world-renowned Wills Eye Hospital. His honors include a lecture series in his name by the New England Ophthalmological Society and the Secretariat Award from the American Academy of Ophthalmology for his work on webinars for clinicians.
Pender is passionate about patient-centered care. He believes that the patient-physician relationship should serve as the fundamental building block for health care reform. He is an advisor to Vxtra Health, a company committed to collaborating with physicians to earn trust and to reduce health care costs. By limiting the drain on health benefits budgets by intermediaries (health insurance companies, pharmacy benefits managers, and hospital systems), Vxtra Health establishes a path toward a new model of care, based on price transparency and fiduciary responsibility, starting with self-insured middle market employers.
He writes on timely medical issues on his website, his KevinMD author’s page, and other popular social media. He is the author of Rebuilding Trust in Health Care: A Doctor’s Prescription for a Post-Pandemic America (2020) and the ebook Standing Up and Speaking Out for Patients and Doctors: First Steps Toward Focused Health Care Solutions (2023).
