That’s why we have to critically listen to patients and reappraise our approaches time and time again. It’s important to know about the immune system and be regarded as experts in musculoskeletal medicine, but if we are not cognizant of the patient’s world, this knowledge is ultimately in vain. If we don’t join hands with our patients and express as much interest in knowing the intricacies of their world as they are interested in learning about ours, we’ll never be able to meaningfully engage in service. It’s certainly not a novel thought. A 19th century aphorism commonly attributed to William Osler goes along the lines of, “It is more important to know what sort of a patient has the disease than what sort of a disease the patient has.”5 But two centuries onward, the gap between individuals, including patients and their healthcare team members, remains large. In many ways, it feels like it’s getting harder and harder to understand patients’ experiences because we are living in more isolated worlds.
Compounding this is the modern trend toward shorter clinic visits, with lower reimbursement for healthcare team members. We’re evaluated, assessed and judged for certain metrics and benchmarks that simply don’t prioritize this mutual understanding. At best, we’re coached into using tricks to improve patient satisfaction scores, but not really connection and engagement. This attitude is even more dangerous when we interface with members of vulnerable populations for whom a thorough understanding of their lives is even more vital.6
We’re All Hungry
Even as a tremendous optimist, I see little hope in the near future to reconcile the big gaps that exist between patients and their healthcare team members. We need to be paid to understand what fueling one’s hunger and boosting one’s immunity mean, more than to dispense medications and write notes. We need champions who look at what we do as not only a transaction for customers but as a public good for our society as a whole. And we need greater grace to ensure that we can persevere in spite of such challenges.
I do see reasons for hope in the longer run. At larger levels, patient advocacy organizations are helping us understand the global elements of patient experience. Social media has provided glimpses into the lived experiences of patients in ways that would have been much more difficult in the past. The stigma of chronic illness is slowly being shed, allowing for more meaningful conversations in the clinic. And journals are much more amenable to publishing research that prioritizes an understanding of the lived experiences of patients. Just as vital is the success of advocacy groups, including the ACR, in interfacing with government at the federal, state and local levels so that value can be retained in clinic encounters.
