“The good physician treats the disease; the great physician treats the patient with the disease.”
This quote is from the renowned physician and teacher Sir William Osler, co-founder of the Johns Hopkins School of Medicine, who lived and practiced from the mid-19th to the early 20th century. During his time, antibiotics were unknown, surgery was still an extremely dangerous proposition and public health measures such as hand washing and the importance of a clean water supply were just beginning to take hold. The wide array of diagnostic methods and treatments we take for granted today were mostly nonexistent.
Yet Osler understood and taught that a strong doctor-patient relationship – whether achieved within minutes or over a period of years – was crucial to diagnosing and treating illness. He knew that it was in fact the cornerstone of outstanding medical care.
“Listen to your patients,” he advised. “They are telling you the diagnosis.”
In today’s high-tech medical world, with its ever-expanding litany of blood tests and imaging studies (not to mention countless medications), it’s easy to lose sight of the fact that a doctor’s most powerful tool remains listening to patients. This becomes particularly challenging in a seemingly always-rushed environment, where time is in short supply and the tendency is often to keep things moving in assembly line fashion.
Yet as physicians, we still rely on our patients to tell us their stories. Given the chance, patients often paint a picture to guide their doctors toward the proper diagnosis and treatment. Having patients feel comfortable enough to do this is a precious trust that doctors cannot take for granted.
Part of every medical school and residency curriculum today includes instruction on patient-interviewing skills and a newer focus on developing and maintaining a strong patient-provider relationship. Many health-care organizations, such as the Palo Alto Medical Foundation, also conduct formal training and observation programs to promote solid and enduring patient-provider bonds. No blood test or expensive piece of diagnostic machinery will ever replace this relationship as the engine that drives exceptional medical care.
This is why I believe that having a primary-care doctor is so important to your overall health. Knowing and trusting your provider makes it easier for you to give us a deeper, more comprehensive picture of who you are. It also allows us to better reflect this in your chart for when you need to see other providers.
Our job in treating you, the patient – either preventively or for a specific illness or injury – requires that we know you as a human being. And no two human beings are completely alike, even if they suffer from the same disease or disorder.
Osler, the grand old father of modern medicine, understood this better than most. His words to his fellow physicians about not forgetting such a basic tenet still ring true today, nearly 100 years after his death: “Every patient you see is a lesson in much more than the malady from which he suffers.”
Dr. Robert Russo is an internal medicine physician at the Redwood City Center of the Palo Alto Medical Foundation.
The Palo Alto Medical Foundation and column editor Arian Dasmalchi provide this monthly column.