Page 32 - LIN March-2023 50-84-sent

The of Medicine

by Svetlana Kogan, M.D.

hen I think of the strengths A doctor who is inundated by all of these woes, is unlikely to
W be able to practice compassion and serve the patient's complex
of our conventional Western
needs instead of trying to quickly fix them. For doctor-patient
healthcare, several things come to
mind. Among them: amazing robotic surgical relationships to work, time spent with each other matters.
advancements, trauma care, and availability of There are many chronic diseases where listening to the whole
sophisticated diagnostic radiology. However, story is of paramount importance: high blood pressure, depression,
the areas where it seems we fall short of our acid reflux, migraines, irritable bowel syndrome, elevated cholesterol,
potential are prevention and chronic disease autoimmune disease, and chronic fatigue, to name few. Instead,
management. If we use the acute care model patients often feel rushed and not heard. I was recently creating a
to name a diagnosis and right away look for a detailed timeline of my 76 year old patient’s chronic illness from
medication to treat it, we will have missed the her childhood to the present, when she started crying and confided
patient's whole life story. That story often never gets a chance of in me that no one has ever asked her before about all these past
being heard, while, it almost always points to the root cause of the nuances of her life.
presenting illness. Patients are also extremely sensitive to how they perceive
The "Name it, Blame It, Tame it" medical care model is one their doctor's attitude towards their illness. And this perception
of the reasons while our healthcare spending is projected to grow affects healthcare outcomes. In fact, a recent study found that
at an average annual rate of 5.4% reaching 6.2 trillion dollars by the less empathetic and less thorough the doctor was during the
2028. Indeed, we have the highest health expenditure per capita encounter - the longer the duration and severity of the illness lasted.
of any civilized nation in the world. In this present healthcare Interestingly, in that same study, not seeing the doctor at all was
paradigm, 55% of Americans take at least four prescription better than seeing a doctor who was perceived to be overly quick
medications a day and the rates of obesity, hypertension and and non-empathetic by the patient!
diabetes are rising in our country at unprecedented rates. Before the heart of medicine is lost, we should focus on
Since the days of my emigration from Ukraine in 1986, compassionate health care in which we listen intently to the
I have observed a rapid deterioration of the heart of our medical patient's story and design the healing protocol in the context of the
establishment. Doctors' time spent with the patients became patient's daily living situation.
infinitely devalued by insurances and this became a no go for Physicians who partner with their patients in addressing social
doctors taking their time to really listen to the patients. In a recent and emotional aspects of chronic illness, have better outcomes in
study of American women physicians, 75% said that managed care patient anxiety, function, symptom improvement, blood pressure
had a negative impact on their practice of medicine, while 77% control, sugar control and pain management. This doctor-patient
were fatigued and burned out. The top reported causes of burnout partnership and collaboration is the heart of medicine which we
were having too many bureaucratic tasks, lack of autonomy, lack of should strive to preserve.
respect from administration or staff, government regulations, and
insufficient compensation.

32 Life in Naples | March 2023