7 Traits of the Ideal Doctor
April 26, 2012
What makes for an ideal doctor? Patients shared their views in a study which appeared in an issue of Mayo Clinic Proceedings. It’s based on nearly 200 patients treated at the Mayo Clinic in Arizona and Minnesota.
In phone interviews with people who had no professional ties with the Mayo Clinic, the patients described their best and worst experiences with their Mayo Clinic doctors, with confidentiality guaranteed. The doctors seen by the patients came from 14 medical specialties.
Who made the list?
Here are the seven traits listed by the patients, along with the patients’ definitions of those traits:
• Confident: “The doctor’s confidence gives me confidence.”
• Empathetic: “The doctor tries to understand what I am feeling and experiencing, physically and emotionally, and communicates that understanding to me.”
• Humane: “The doctor is caring, compassionate, and kind.”
• Personal: “The doctor is interested in me more than just as a patient, interacts with me, and remembers me as an individual.”
• Forthright: “The doctor tells me what I need to know in plain language and in a forthright manner.”
• Respectful: “The doctor takes my input seriously and works with me.”
• Thorough: “The doctor is conscientious and persistent.”
That list isn’t in any particular order. The researchers didn’t check whether confidence was more important to patients than respectful treatment, for instance. The Mayo Foundation funded the study.
The traits covered doctor’s behavior, not technical know-how. That finding “does not suggest that technical skills are less important than personal skills, but it does suggest that the former are more difficult for patients to judge,” the researchers write.
They add that patients may tend to assume that doctors are competent unless they see signs of incompetence, the researchers add.
One patient put it this way in the study: “We want doctors who can empathize and understand our needs as a whole person. We want to feel that our doctors have incredible knowledge in their field. But every doctor needs to know how to apply their knowledge with wisdom and relate to us as plain folks who are capable of understanding our disease and treatment.”
The opposite of those seven traits would be: timid, uncaring, misleading, cold, callous, disrespectful, and hurried. Can healthcare ever be high quality if the patient-doctor interaction is any of these? Technically, the care can be high-quality but is it really a place that you want to be treated?
What Would You Do?
April 16, 2012
The ABC show, “What Would You Do?” with John Quinones, is a reality show using a hidden camera that puts ordinary people on the spot with ethical dilemmas. From bullying to abuse, racial attacks and children using foul language in public, the show is geared towards the reactions of unsuspecting people put in uncomfortable situations.
It is interesting to see how people handle these interactions. Many people step up and engage in the situation and many others step aside with the notion that it is none of their business. Last week I presented an ethical dilemma but this week is about a question I get asked almost daily, “What Would You Do?”
When people come to me with dental problems and I present different options, they often ask me this question. It is difficult sometimes putting myself in other people’s shoes so I use a concept I learned long ago from a mentor which is – Would I Do It On Me? The acronym is the WIDIOM rule.
Most often there are at least a couple of different acceptable ways to handle dental problems. When someone asks what I would do if I was in their situation, I look at it just like that – If that tooth or those teeth were mine, what would I do knowing what I know?
Let’s look at a specific example. A patient comes in with a tooth that has a big problem. The tooth has extensive decay that involves the nerve and extends below the gum line. I explain to the patient that the tooth can be saved with root canal therapy, some minor gum surgery and a crown or the tooth can be extracted and replaced with a dental implant. The other option is to remove the tooth and leave the space. The patient then asks me the question, “What would you do?”
Any of the treatment options above would be an acceptable way to treat this problem. Depending on the circumstances, I may choose any of the treatment options. I may choose to extract the tooth and not replace it if the tooth is not going to impact me functionally or esthetically. If “my” homecare is poor or if “I” do not visit a dentist regularly, I may choose the dental implant option because of long-term predictability.
This is just one example. Patients also frequently ask me about orthodontics, wisdom teeth and certain cosmetic treatments. In my experience, about 75% of the time the patient ends up doing the treatment that I would do. Regardless of their decision, it seems that for those that ask this question, the information helps them in making a decision that is best for their individual circumstances.
As I was working on this column one morning last week the news became flooded with the “controversy” over dental x-rays and their relationship with a type of benign brain tumor. As I listened to the typical distortion the media puts on everything, I started to do some research on the study.
Next week’s column will address this story. I will discuss the facts of the study and how they relate to the typical dental patient. It never hurts to ask your dentist, “What would you do?”
Ethics in Advertising
April 2, 2012
I was listening to the radio on the way home from work the other day and heard an advertisement for a dental office. The ad stated that they were specialists in cosmetic dentistry and implants and that they are the “premier” dental office in the area.
There is no recognized specialty in cosmetic dentistry or implants. Therefore, claiming that you are a specialist for either of these two areas is both illegal and unethical. While it is not illegal to say that you are the “premier” office, it too is unethical for advertising in dentistry.
While I have no problem with legal and ethical advertising in dentistry, what concerns me is over-advertising. The last thing the field of dentistry needs is the public looking at dentists in general as opportunists, and not as dedicated and concerned professionals. How this plays out in the long run will be decided by the ethical standards practiced in dental offices and the rules and regulations enforced by the governing within the profession.
Ethics is about doing good and the concept of right and wrong. Things that may be legal may not be ethical. On the same note, procedures that a dentist is not properly trained in or does not have the technical ability to perform, at least within the standard of care, may be legal for that dentist to do but not ethical. “”Do no harm”, should be the first item on the list of any dentist or any other healthcare provider.
Unfortunately there are healthcare providers, including dentists, who think they are doing people good but don’t realize they practice outside of their true ability. In 1952, the legendary (in the dental world) Dr. L.D. Pankey said, “It’s the moral obligation of the dentist to bring his ability up as close to his capability as possible in accord with his talent. Learning the technique is not enough. A dentist needs to learn how to take care of the whole person.” That is as relevant in 2012 as it was in 1952.
A healthcare professional’s core protocol should be prevention and the quest for determining an individual’s risk for future disease even before the patient has expressed concern. There is a push in dentistry to treat patients based on more objective data, which is commonly referred to as evidence based dentistry. Basically, information about a particular situation is fed into a database containing a multitude of clinical research and “the computer” spits out the best treatment options for that situation based on research. What this does is to minimize the emotionally and empirically based part of the clinical decision making process. My only issue with this is that the empirical, or practical experience of the provider, plays a key role in deciding what is best for a particular patient based on an individual’s unique circumstances.
Cosmetic dentistry poses a different challenge because it is highly discretionary. The dentist, or cosmetic surgeon if we are talking about medicine, must be the patient’s advocate and remain more concerned about the patient’s issues and wellbeing than their own. The benefits of treatment should always outweigh any possible negative consequences. Sometimes the best treatment is no treatment. Sometimes the best treatment for an individual patient is cosmetic enhancement because the benefits of this treatment will have a positive impact on their life.
Any general dentist does “cosmetic” dentistry and most at least do parts of implant procedures. As in any profession, there are varying degrees of talent. Your comfort level with the dentist and the office in general is most important. If you are interested in something that you hear advertised, ask your dentist. He or she probably offers those services.
