Relationship-centered care

We do our work via our relationships. This includes relationships with patients, colleagues, nurses, physician assistants, other professionals, and institutional leadership. Those relationships may be brief and relatively limited in scope or longitudinal and quite deeply involving. Trust, respect, integrity, empathy, and affective engagement are among the reciprocal duties of participants in healthcare relationships; when our relationship are not working, we must reestablish these elements. Our relationships are key to the well-being not only of patients but of everyone in the healthcare web.

Begin to understand healthcare relationships with Relationship-centered Care; A Constructive Reframing, by Mary Catherine Beach and authors from the Relationship-centered Care Research Network in the Journal of General Internal Medicine, 2006;21:S3-8 and An Endangered Ethic - the Capacity for Caring by Marin A. Adson in Mayo Clinic Proceedings 1995;70:495-500.

Anatole Broyard’s Ideal Physician

[W]hat do I want in a doctor? I would say that I want one who is a close reader of illness and a good critic of medicine….not only a talented physician, but a bit of a metaphysician, too. Someone who can treat body and soul. I can imagine [my ideal doctor] entering my conditioin, looking around at it from the inside like a kind landlord with a tenant, trying to see how he could make the premises more livable. He would look around, holding me by the hand, and he would figure out what it feels like to be me. Then he wold try to find certain advantages in the situation. He can turn disadvantages into advantages…We would wrestle with my fate together.

Anatole Broyard, Intoxicated by My Illness; And Other Writings on Life and Death. Fawcett Columbine 1992.

PATIENCE

"PATIENCE SEEMS TO BE MY GREATEST NEED AS I PRACTICE MEDICINE AND IT IS THE SKILL I HAD THE LEAST TRAINING IN AT HOME OR AT SCHOOL. SURELY DOCTORS GET IN TROUBLE MORE FROM LACK OF PATIENCE THAN FROM INABILITY TO REPRODUCE THE COMPLEMENT CASCADE FROM MEMORY. WHY AREN'T WE TESTED ON PATIENCE/IMPATIENCE? I WILL PUT PATIENCE IN THE CATEGORY OF GREAT THEMES THAT ARE CRITICAL FOR THE PRACTICE OF MEDICINE THAT ARE SELDOM MENTIONED, LIKE THE FACT THAT WE ARE GOING TO WORK WITH SICK PEOPLE, WHO ARE SUFFERING FROM LOSS AND FEAR AND INCREASING DISABILITY. NOBODY EVER TOLD ME ABOUT THAT. MY TEACHERS ASSUMED THE DAILY PRACTICE OF MEDICINE WAS LIKE CHILDBIRTH: THE UNINITIATED HAVE NO CONTEXT FOR APPREHENDING THE TRUTH OF THE EXPERIENCE, AND THOSE WHO DO FIND IT TOO PROFOUND TO DESCRIBE."

FREDERIC PLATT. CONVERSATION REPAIR; CASE STUDIES IN DOCTOR-PATIENT COMMUNICATION. 1995. LITTLE, BROWN & CO..

A Month Of Quotations

Welcome! During the month of September 2018, I will post a quotation more (or less) weekly . These quotations come from literature that has been formative or affirming for me as a physician and/or as a coach. Each of these quotes comes from a book or paper that I commend to you for reading in its entirety. In kicking this month of quotes off, I say, "Thank you" for your interest!

To begin: a short one.

"To be a professional in the full sense is to understand oneself as claimed by a practice that derives its integrity from service to others." William M. Sullivan, PhD, Foreward, Teaching Medical Professionalism, Cruess RL, Cruess SR, Steinert Y., ed. Cambridge University Press 2009.