“It Is Not You, It’s Me”

The “My doctor is a d*ckhead” represents the perfect get out of jail card for the 21st century.1 Welcome to the age of “it’s not my fault, it’s yours,” “I’m great but you suck,” and “if I don’t understand then you didn’t explain.” Welcome to a world where insulting somebody has morphed into empowerment.

“There is an assumption that doctors should just tolerate these insults, but what is less well understood is the profound and harmful nature of rudeness. Mean spirited insults close off the necessary wisdom, communication, and relationships so necessary in complex healthcare. We should all get more comfortable with life’s hardest sentence: “I don’t know.” Nobody gains by leveling harsh accusations at fallible humans, regardless of their proximity or salary. Doctors are not dickheads, we are just heads, and, like our patients, these heads are connected to hearts.” 1

Who is to blame the doctor-patient?

I recently read a blog that looked at doctor-patient relationships. It examined an “it is you, not me culture”. This had me thinking about some of the blame games that I might participate in as a patient. I just want to put a disclaimer out there, I have, at times, had a tumultuous relationship with my doctor and have had many moments of frustration working on shared decision making goals and understanding each other. It is easy to blame each other for miscommunication or hurt feelings. How can we build each up as opposed to creating even larger divides in these relationships?  What do you think would level the playing field? Do we need base playground rules? Be kind, be compassionate, don’t be a jerk? Is there an education piece that would work best? Sometimes I think about what would I like to say to my physician if I could. A lot of what I want to say is, “you are not actually listening to me, but I would appreciate if you would. I think it comes down to understanding what the value of the relationship is. At a recent appointment, I was knocked off my game when my appointment was interrupted so my doctor could deal with a patient who did not want to stay for their consultation because they needed to get on a bus to get to work on time. My doctor went into a diatribe about these patients, that he can only help those that want to be helped. It was a valid point but there was almost no appreciation that this was derailing my appointment and didn’t exactly leave me feeling cared for.

There are better ways to connect

The statement that resonates with me the most is the “ If I don’t understand then you didn’t explain it”. In my experience, I feel that physician sometimes feel that they have thoroughly explained something when actually they have potentially glossed over important details, like side effects, effectiveness or even instructions. For example, are things really as clear as they think they are? I know that I have had occasions where I later questioned something that I didn’t know that I was supposed to do. I know that we are all human and being a jerk does not help the situation, however, what are the best ways to connect. Should we as patients not call out bad behavior?

What are your thoughts?

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View References
https://blogs.bmj.com/bmj/2018/11/01/matt-morgan-and-peter-brindley-doctors-are-not-dkheads-but-they-are-human-bei

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