Medicine has long prided itself on building relationships between providers and patients. It’s a sacred trust that sets medicine apart from other industries. There’s a conflict, however, between the romanticism of old medicine and the new realities of populations and technologies - time.
Physicians used to enjoy ample time to explore a single patient’s health in multiple aspects and developed a system of recording and organizing the information solicited during that lengthy encounter. The patient-physician relationship was nurtured in depth during a single point in time. These “vertical visits” allowed time for highly personal and therapeutic relationships to develop.
Modern medicine has new challenges to face - more patients, fewer doctors, and even less time. The structure of the appointment, however, has only been compressed, not adapted. Physicians are still using the old methods of soliciting health information in an environment for which they were not developed.
Now we complain that 15 minutes is hardly enough time to mine actionable information, make a diagnosis and plan, and form a meaningful relationship. We, too, are human; we can only do so much.
There needs to be a shift into a more longitudinal relationship between patient and provider, where both health information and therapeutic rapport is built gradually over time and with the aid of inputs that allow patient information and rapport to self-assemble.
Technologies like trackers and sensors will undoubtedly play a role in this, as will physicians’ public presences in passively developing relationships. The bigger challenge, however, will be the cultural frameshift in what the clinical encounter means and how it plays out - both for providers and for patients.
Given the growing burden of chronic disease, longitudinal relationships seem to be more therapeutically resonant with those diseases’ time courses than singular encounters. Of course, one might argue that this is the job of the primary care provider, but even PCPs are feeling the time crunch.
Ultimately, we’ll be offloading part of the physician’s duties onto digital technologies that help monitor, report, and treat patients’ issues over time, such that physicians will be able to better leverage their time in clinic for more pressing health matters.
Or maybe I’m just on the wrong track.
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Asked by Anonymous
It all depends on how you consider it; what sacrifice is to one person is completely normal to the next.
Personally, I don’t feel like I sacrificed much getting into med school, apart from the occasional sleepless night. I stuck with my engineering major, despite premed advisors warning me that it would be harder than just switching majors into biology, and still landed in the top 15% of my class. I graduated with a good group of friends, socialized as much as I wanted, and never felt alone. I’m as close with my family as I ever have been. I joined clubs, played sports, and had plenty of professional opportunities. In hindsight, college was good to me.
To an observer, however, it might have looked like I studied too much, partied too little, and had very few friends. That is all perspective though; the observer may just be accustomed to a certain way of living and mine doesn’t stack up. From my view, I got to do what I loved, what challenged me, and what helped me grow as a person and professional.
If med school truly is your dream, nothing you do or don’t do in college should be a “sacrifice”. Change your perspective, so everything becomes a stepping stone towards success. Frame your life positively and everything becomes better.
I’m going to be on my very first panel! At Stanford University, no less!
Tumblr’s very own chroniccurve joins me and some other stellar folks on stage at Medicine X for a discussion on how we can improve communication between patients and providers. These days, it seems that the medicine has fundamentally changed in the face of new pressures. We’ll be delving into topics like that and more to explore how we can concretely improve what makes the medical profession so unique - the patient-physician relationship.
If you have any ideas, suggestions, or stories to share (I’ll maintain your anonymity!) leave them here, send me a message, or shoot me an email at firstname.lastname@example.org! I’d love to hear about any thoughts on the subject.
amolutrankar and kvnwng, my co-hosts at the H&P, got a chance to interview one of Tumblr’s favorite docs, cranquis! Check out this hilarious interview with the good doctor (his voice has been altered to protect his anonymity) and let us know how we’re doing with the podcast! Remember to give us 5 stars on iTunes so we can continue producing!