The Worcester District Medical Society published their recent magazine (July/August 2009 edition) entitled, "Worcester Medicine-Health Professionals and Patients: Can't We All Get Along," (Part 2) that printed several articles on different topics pertaining to the doctor/patient relationship.
One particular article entitled, "Understanding Humiliation" by the Dr. Aaron Lazare, MD, talked about how diagnostic labels such as hypertension, heart failure, psychiatric disorder, just to name a few, can be demeaning and decrease a patient's sense of dignity. Some of the patients he interviewed responded to his question, "How did the situation that brought you here (hospital or clinic) make your feel?" Some of their responses were: "like an animal," "like a welfare patient," "like I did not matter," "like a person without any rights," and "like a nobody."(P.11). Further, some patients also felt degraded when their doctors criticized their behaviors such as excessive drinking, weight gain, etc.
Dr. Lazare's attributed some possible reasons on why doctors and medical students may respond to their patients these ways:
* Not enough time with them(patients)
* Their (Patients) unreasonable expectations and demands
* Doctors/Medical Students feeling inadequate as a result of their own personal issues of perfectionism and dealing with overwhelming knowledge of information they need to know in their jobs
* Fear of malpractice suits
How can doctors learn to be more self-compassionate people with their patients?
Dr. Lazare teaches doctors about the emotional impact of humiliation on their patients as well as for themselves. Dr. Lazare's talks about the importance of offering an apology when appropriate and admitting to making a mistake to your patients. This solution makes patients feel that their doctors care about them by increasing their trust in them and being able to be more open with their doctors.
What can counselors take from the above information: I look at this opportunity as threefold:
1) Counselors can become more self-aware of how we treat our clients when we are feeling pressured on our jobs. For example, if you work in a family clinic, you are required to fill out treatment plans and quarterly reports in order to be paid by insurance companies. Other examples include taking on more clients to make a "liveable" income and responding to emergencies that can take all day to resolve, that is, if it is solvable. For those in private practice, the pressure can be to recruit and to retain prospective clients to stay in business. Other issues are trying to balance some of your clients' unreasonable and high demands for therapy outcomes due to their investment and time in seeing you. We need to be cognizant if we offend our clients in anyway and offer offer an apology
when appropriate.
2) Counselors need to be sensitive to how they process their clients' diagnoses with them. Sometimes, counselors can forget that the client is a person first before the diagnosis. Counselors also need to empower our clients to not be stuck with the "labels" but to see it as a small part of themselves that they need to manage on an ongoing basis.
3) Counselors can teach their clients that they have the right to be treated with respect and dignity at the hospital and in the doctors' offices. Counselors can refer them to the appropriate resources that can help them resolve their complaints if they choose to file one. Counselors can also work with them on their feelings of humiliation they experienced and to teach them coping skills to decrease their symptoms. However, if some of your clients act inappropriately in these places, you need to work with them on how to be more patient and to act in a dignified manner with an imperfect healthcare system.
I would like to see articles on teaching counselors similar communication and customer services skills that medical students and physicians receive in hospital settings.
What do you think?
Robbin Miller, LMHC
Facilitator
http://www.robbinmiller.vpweb.com/.
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