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When listening to patients, don't Fijit
Last week, my children’s favorite aunt, who works in marketing for Mattel, gave my 7-year-old daughter a brilliant toy called Fijit. Fijit is a 9-inch-tall robot that talks to kids, tells them jokes ("Why was Cinderella such a poor soccer player? Because she kept running away from the ball!"), dances to music that you play and then asks, "What do you want to do now?"
Needless to say, Fijit has provided my kids with hours of entertainment. As I’ve watched them engage in conversation with this plastic, computerized toy, I’ve realized how much it mimics the human interaction that can happen between doctors and their patients.
When a clinician sits down with a patient who is having a problem, we seek to understand their needs, but how often do we actually fully focus and pay attention? Studies show that most doctors in most patient visits have a pretty good idea as to the diagnosis and proper treatment within seconds of hearing the patient’s initial complaints. (A great book on this topic is How Doctors Think by Jerome Groopman.) While we may probe for more confirmatory history, usually we are seeking to reinforce our initial diagnosis rather than question it and move in a different direction that might better suit the patient. Rather than actually listen, we type information into the computer, start writing prescriptions or let our mind drift elsewhere, meanwhile risking a wrong diagnosis.
To be a truly helpful physician to my patients, I have to remind myself occasionally to deliberately delay deciding on a diagnosis until I have heard and seen all the information that could lead me in an unexpected direction. Often I find what would have been my initial diagnosis was wrong, and I perform at a clearly higher level for having taken this step of extra care. Wouldn’t we all want to be treated this way?
In an environment in which health care is being devalued and doctors are becoming commoditized, it is ever more important that we as physicians elevate our status by performing at our highest level. Otherwise, we might as well be replaced by a small plastic robot sitting on the counter asking the patient, "How can I help you today?"