Editor’s Note: Physicians Practice’s blog features contributions from members of the medical community. These blogs are an opportunity for professionals to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The opinions are that of the writers and do not necessarily reflect the opinions of Physicians Practice or UBM.
I was at a conference last week which always helps me reset professionally. One quote shared by a plenary speaker was from Patch Adams: “You treat a disease, you win, you lose. You treat a person, I guarantee you, you'll win, no matter what the outcome.” As I saw patients in clinic today, I thought about things differently—what if I did treat Mary, Stuart, Lee, and Pamela rather than CHF, Diabetes, Asthma, and Depression?
One of my patients has an emotional sickness that manifests all over her body. She has experienced one blow after another and now finds herself racked with pain. Another patient has intolerable back pain because of her job. If she wants to alleviate the back pain, she needs to find another job, but this is not easy. One young patient who is essentially homeless and uninsured despite working full time needs a generic antibiotic but cannot afford the $12 co-pay. A patient with many chronic medical problems skipped an important diagnostic test because the co-pay was too high, and he cannot afford over the counter cough medication until he gets his next check.
The treatment these patients need cannot be packaged in a pill form. True treatment of the person involves so much more. However, those are the moments that make me feel incapable and impotent. I can be a sympathetic ear when I listen to patients describe the many trials they are facing, but I can’t solve them. The myriad complexities, inequity, instability, and inconsistencies in our current healthcare system seem to be unsolvable. Homelessness, joblessness, poverty, and broken relationships haunt my patients relentlessly and are the true health concerns they face. Yet these are the very problems I have few resources to address.
Caring, being empathic, and even being mindfully present can alleviate some of the suffering my patients experience. However, the human, rather than the distant professional, side of me wants to step into some of these spaces and help in a different way. I know that I can’t cover every co-pay a patient can’t afford, but I could’ve covered this one today. I’m not in the vocational rehab business, but I know of some job openings that may benefit my patient. That instinct to help has been trained out of me, and I recognize that this is for some good reasons. Saving everyone would surely crush me under the weight of unmet social and societal needs. Maintaining objectivity does allow a physician to make certain decisions and do certain things that are necessary and hard.
So, I’m left wondering how to best treat my patients—how to balance the medical with the “other”—whether that is heartbreak or hopelessness. I may have found success at the end of my day with a lovely patient who is battling depression. At our last visit, he bowed under the weight of his life. I adjusted one medication, made some recommendations about his work environment, encouraged time in nature and in the sunshine. The medication change didn’t work—too many side effects. However, the changes to his work environment and spending time outside helped immensely. I need more treatment plans like this one.
Jennifer Frank, MD, is a family physician and physician leader in Northeastern Wisconsin and finds medicine still to be the best gig out there. Married with four kids, she is engaged in intensive study and pursuit of work-life balance.