Doctoring Health Care Reform Reflection

An antidote for inflammation

Being mid-week, I had planned to tell you about the recent news concerning the role of fitness as a predictor of real outcomes. Important as this is, it will have to wait.

I’ve got something much better. Though it isn’t about exercise; it is about health and happiness and soothing inflammation.

Writing this year’s best opinion piece in the Wall Street Journal, the president of Notre Dame, Father John Jenkins, makes the case for persuasion as the cure for incivility.

He is talking to the political parties, addressing the toxic rancor on display in recent times, but it strikes me as applicable to more than just politics. May I dare think about healthcare reform or patient care?

His argument is captured in this passage:

If I am trying to persuade others, I first have to understand their position, which means I have to listen to them. I have to appeal to their values, which means I have to show them respect. I have to find the best arguments for my position, which means I have to think about my values in the context of their concerns. I have to answer their objections, which means I have to work honestly with their ideas. I have to ask them to listen to me, which means I can’t insult them.

This is refreshing, isn’t it?

Those of us ensnared in the debate on healthcare delivery could learn a lot from this message. Think about it. At the core, I suspect doctors, industry and policy-makers all want the same thing: a more efficient system that provides better care for fellow mankind.

I’ve said this before: doctors’ self-esteem hangs on how much good they do for patients. It’s the same with medical industry: they aim to build better products. Industry is not the enemy; without innovation, we would be practicing medicine without any tools. Imagine treating a heart attack without a stent or a cath lab. And even policy makers and regulators aren’t villains. They also hope to engineer a more cost-effective and inclusive delivery system for all the citizens.

More and more, it seems the parties involved have grown uncivil.

In patient care, almost all doctors have faced this difficult scenario:

You are about to go see a sick patient. The nurse tells you beforehand that the family and patient are upset. You might even have been told they are angry mean people. You look down the hallway of the ward and see the stern faces of family members in angst. In almost every case, the way out of this trouble is the same:

You go in to the room and display warmth. You ask what the patient and family see as the medical issue—not what others say it is. Then you listen. Invariably, the picture becomes clear. You understand their position. And for the win: you try to persuade them in the context of their concerns. This works almost all the time, whether there is a cure or not.

It is easier than you think.


2 replies on “An antidote for inflammation”

Great post John! The difference (in my opinion) is that we as medical providers realize that the patient’s welfare is the MOST important thing – so we act with this foremost in mind. This is NOT what I have personally observed with our current political system … and I believe that is what is most frustrating about current gridlock about virtually every position brought up even before true “discussion” is ever begun …

Beautifully put. Of course all this communicating and talking and listening takes time, sometimes a lot of time. My hope for all doctors is that we take the time it takes. My hope for all patients is that they do the same. My hope for healthcare reform is that this effort is recognized as important.

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