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She writes a monthly column about the uncertainties, dilemmas, and stories that patients and doctors share in practice.
C., located in Danvers, Massachusetts, provides patients of all ages with skilled and compassionate care. The practice motto is "team work," and the staff works together to achieve better health and wellness for patients every day.
More often then not they were mutually reinforcing.
I suppose I can’t prove it, but I am convinced that her frequent trips to my office, during which we talked at least as much about presidential campaigns, skirt lengths, and bestsellers as about her arthritis and digestive difficulties, helped prevent Emma from being hospitalized as older people, particularly those who live alone, so often are.
To acknowledge this shift, there was a movement a few years ago in which doctors were encouraged to refer to patients as “clients.’’ This term, which psychotherapists, physical therapists, and other clinicians often use, is meant to imply a respectful, collaborative relationship in which the medical professional doesn’t hold disproportionate power. And in at least one study, patients asked about the term “client’’ said they didn’t like it, either.
A 1994 survey of several hundred American physicians found wide variation in attitudes about having lunch with, hugging, or even dating patients.
My role models were those legendary physicians of the 19th century whose oil portraits had lined the walls of the hospital in which I did my medical training. James Jackson of Massachusetts General Hospital summed up their philosophy in his 1855 book “Letters to a Young Physician.’’ He advised that a doctor should maintain a calm and neutral attitude with patients, “abstain from all levity,’’ and, most important, “never exact attention to himself.’’As my colleague Jim predicted, I found this standard nearly impossible to meet over time.
The team believes in working closely with patients to establish a trusting long-term relationship.
When his daughter and I ran in from playing in the yard and opened the refrigerator looking for a snack, we saw vials of insulin and penicillin lined up next to the chocolate milk. While the days of the home office, house call, and 24/7 solo practitioner are mostly past, my patients often view me as a partner in, rather than a director of, their medical care.
They treat me more familiarly than my dad’s patients treated him. Or perhaps it’s because “client’’ connotes a party in a business transaction, and that doesn’t capture how we feel about our patients - or ourselves.
Even seemingly straightforward medical questions - “Should I try to have a child at 40? But so often the real question patients are asking is: “What would you do if you were me?
’’ It is, at least in part, a personal question that implies and nourishes a personal relationship - but how personal should that relationship be? Over the years I’ve found myself answering more and more openly, feeling that, ultimately, these questions mirror concerns my patients have about their own lives.
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When Emma died, at 94, a small crowd gathered for her funeral.