Tuesday, November 29, 2005

Solitary Profession...How Does One Improve?

I just read this interesting New York Times article titled When the Doctor Is in, but You Wish He Wasn't. It's an article about the problems patients sometimes have with the "bedside manner" of their doctors. It's a pretty short article so you may as well give it a read.

Anyways, the first thing I reflected upon is the relationship I've had with my doctors. To be honest, I haven't really had problems with my docs. That's probably because I rarely have reason to go. The second thought I had was about the method which my health organizations use to determine the quality of bedside manner their doctors are providing. I've always had coverage through large HMOs or networks. Currently, I'm with Kaiser and I'm going to be sure to ask my friend how Kaiser determines such things (or she could leave some commentary here, hint, hint)

And interestingly enough, the final thing I thought about before deciding to blog about this article was the solitary nature of being a doctor and how that compares to the work that I've done in my life.

This thought came to my mind as I read the end of this article where the consultant asks the doctor to change the way he listens to his patients. I immediately thought about a workshop we had at work where we learned some active listening techniques to learn more about the real thoughts that the other person has and what they reall want to say. That lead me to think about how when I'm at work, I tend to rely on the thoughts, advice, and opinions of my colleagues as I work and before I make big decisions. This is the same for my photography work. While it's a very different line of work, I rely on my partner for creative advice as well as her thoughts on how I'm doing with my work. And this is while I'm working, not after. I feel like I improve at my work all the time through this sort of groupthink. It's a circular thing which allows both myself and my partner or colleague to improve how we work and our results.

Given the description of some doctors work, I wonder how they really improve themselves over time? The article notes the doctor who modified the way he listens to patients, but it's not something he can get pointers on while working. Granted, I don't think most of us need busy-bodies telling us how to do things while we're doing them, but there's a difference between getting consultative advice or training and collaborating with someone to improve as you go.

At the very least, I can ask a colleague, "Hey what do you think of this?" before I actually do something egragarious. I'd imagine that it's difficult for a doctor to do something like that. They can certainly bring in a colleague for a consult, but that seems like such a big deal. So big that the doc has to stop what he's doing because he's not sure and then find someone who can tell him how to proceed. I'd guess that the impression that a patient gets when this occurs might deter some doctors from getting just the advice they might need. And moreover, the advice is usually about some sort of fact, not a soft skill like bedside manner.

As such, it seems like that outside of medical conferences, board reviews, and such, doctors lead a very solitary profession. In such cases, how can one really improve? Books, training, and consultations can only take you so far. What other ways could skillsets be improved for the sake of all?

I don't have any close friends who are docs so if anyone reading this is a doctor, is in med-school, or has a close doctor friend, speak up!

1 comment:

Anonymous said...

How does KP determine quality...surveys! I've gotten soo many surveys on the quality of care i've received from my docs (yes, I always return them!) but its only one of many ways. All Health Plans go through CCHRI (i forget what the entire acronym stands for but its a consumer organization) and the wonderful Consumer Reports people (hey KP has ranked #1 in some regions and is usually in the top ten...)

As for doctors and getting advice, I think it depends on the type of organization they are in...I worked in clinical trials and there were several docs around...sometimes on tough cases they consulted each other. From my grad program, we had a Med Group CEO tell us they had weekly meetings of doctors who brought their tough cases as a way for them to get advice of other docs on treatments. I think it depends on the doctor and the nature of the case on whether they seek help or not...