Close-ups

A Patient’s Perspective

Time to Chat

Am Fam Physician. 2010 Aug 1;82(3):282.

D.P. (left) with Dr. Michael P. Madwed.

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D.P. (left) with Dr. Michael P. Madwed.


D.P. (left) with Dr. Michael P. Madwed.

Now that I’m 90 years old, I suppose you could say that I’ve seen a few doctors. I was more than three years into my pre-med program when World War II hit. I would’ve probably gotten used to spending time with doctors if I hadn’t chosen a career in business when I came back from the South Pacific. However, it hasn’t made much sense to me why doctors seem so short and abrupt, or why they were impatient with the unusual symptoms that I developed as I got older.

Twelve years ago, I was struggling with worsening chronic obstructive pulmonary disease (COPD), and I switched to a new doctor. When I scheduled my appointment, I was suspicious that a doctor’s interests were strictly to make a decision, walk out, and say over his or her shoulder, “I’ll have the nurse write up a bill and give it to you.” Well, this new doctor turned out to be very different from those that I had seen in the past.

The first thing I noticed about him was his pleasant baritone voice. He walked in, stuck out his hand, and immediately made it clear that this was going to be a friendly encounter. He discovered my interest in politics and connected with me on current events. He also had a fine sense of humor, which I believe is an essential part of developing a good relationship. Over time, I began to trust him a great deal and consider him a friend.

I think my doctor noticed that my COPD symptoms weren’t under the best control, and that I sometimes wasn’t able to gather my thoughts in a sensible fashion. So, he suggested that I start coming in once a month. I am grateful that he spends so much time with me and allows me to ramble on, so that he can figure out what is going on. As you grow older, you develop pains and problems, and you question whether or not you should just live with them.

I’ll always remember my doctor calling me at home the night of the last presidential election. I wondered if I was sometimes over-the-top with my political talk in his office, but I was delighted when he took the time to call me on such a monumental night. The way my doctor takes the time to care about me as a person has made all the difference to my health and to how I view doctors in general.—d.p.

COMMENTARY

I have seen D.P. in my office every month for the past 12 years. It has proven to be the best way to address his many health issues. D.P. is quite a character. He often comes into the office wearing headphones, with National Public Radio blaring. He loves to discuss current events, and over the course of time, he has shared interesting stories with me about his life. Although I was on sabbatical at the time, I called him from my home when President Obama was elected. I felt compelled to do so, out of a sort of devotion to our longstanding dialogue about political issues. I am very humbled to read his words about our relationship. It has been an honor to be his family physician.

MICHAEL P. MADWED, MD, with BLAIR A. BECKER, MD

RESOURCES

For Physicians

Taylor K. Paternalism, participation and partnership–the evolution of patient centeredness in the consultation. Patient Educ Couns. 2009;74(2):150–155.

Barry CA, Stevenson FA, Britten N, Barber N, Bradley CP. Giving voice to the lifeworld. More humane, more effective medical care? A qualitative study of doctor-patient communication in general practice. Soc Sci Med. 2001;53(4):487–505.

For Patients

American Academy of Family Physicians (Web site: http://familydoctor.org)

Close-ups is coordinated by Caroline Wellbery, MD, associate deputy editor, with assistance from Amy Crawford-Faucher, MD; Jo Marie Reilly, MD; and Sanaz Sara Majd, MD. Questions about this department may be sent to Dr. Wellbery at afpjournal@georgetown.edu.

A collection of Close-ups published in AFP is available at http://www.aafp.org/afp/closeups.

The editors of AFP welcome submissions for Close-ups. Guidelines for contributing to this feature can be found in the Authors' Guide at http://www.aafp.org/afp/authors.


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