What Makes a Good Doctor?
I have needed in my long life to go to scores of doctors for both urgent help and also just to ask about some niggly thing. Here are some characteristics I’ve noticed of a good doctor plus a few of my memories of experiencing medical help.
The helpful GP will have intelligence (there’s a lot to know and deal with); they’ll have a degree of love for their fellow person, call it altruism, wanting to help people in need. There will be an ability to deal with complexity, to relate to older patients, especially with comorbidity on the increase (that’s the existence of two maladies in people – for example, diabetes and depression).
The good doctor will realise that disease treatment and the person go together. A doctor and patient relationship must be created. Doctors will be able to listen carefully, give a correct diagnosis, help the patient to understand their illness and also have the awareness that there’s a healing agent or helper in the act of engaging closely.
In general doctors need help with people skills. There’s always one patient a doctor doesn’t much like, the same as a teacher and a student, something I well know. They must be curious about their patients’ maladies, although some patients make it tricky by holding their doctor in some authority role, able to fix anything. Docs need to be more aware of that kind of thing.
A good doctor is glad a patient has looked up beforehand what’s possibly wrong with them. It helps him to relate more easily and educate the patient. He should look at the causes and the meaning of the illness. Maybe it’s a case of advising someone to stop working so hard, to seek out more specialist advice, see to diet and exercise or give up bad habits.
Young doctors, being bright, tend to be very keen to learn in their profession, so there’s a role there for senior doctors to help them.
Doctors should operate to standards, no matter what their personal feelings are about a situation. They must be able to deal with suffering, not an easy thing.
Many doctors have a fear of failure, of not noticing something or giving the wrong diagnosis or medicines. They have to realise they can’t work miracles all the time, can’t be totally effective for every patient; they should give themselves a break. It’s a complex interaction, a doctor and patient, and they need to be more aware of that, especially when a patient expects a doctor to solve all problems. This can be quite difficult.
As I noted already I have visited doctors and hospitals on many occasions. If I can say here, I think my trust in the services was one of the greatest aids to my overcoming many of my maladies, maybe the not so serious ones. This is the placebo effect, one I believe much used by the medical profession itself, encouraging the healing power of the mind.
Sometimes one can simply be told there’s nothing wrong. One of the daftest consultations I had was as a teenager. I had noticed some lumpy things at the back of my tongue. The doctor was oldish, I think smoking a cigarette! He took a look then asked me to look in a mirror at them. I said, “I can see them!” He said, “They’re your tastebuds, nothing to worry about.” I don’t think he charged anything.
Then there was a life-saving operation, also a long time ago. I was in third year at university and one night got a hellish painful stomach. My school friend studying medicine told me to stop worrying, it was probably just wind. I got the first train home in the morning. My mother took me to the doctor who wasn’t sure what it was, saying, “It’s the wrong side for appendicitis.” He referred me to a specialist at the hospital, a surgeon who knew that appendix pain always presents at the opposite side. He said, “We operate immediately!” and within a couple of hours had taken out my appendix which was about to burst! The GP who referred me certainly showed what a good doctor does in his ability to refer me to a specialist. I wouldn’t be typing this otherwise!
Another life-saver was much more recent. I had to see a doctor for a checkup for my driving license, my being over 75. He was a young man with excellent hearing, allowing him to pick up a faint heart murmur. This led to various visits to cardiologists and the usual ECGs before being admitted to hospital a couple of years later for an operation on a heart valve because I had “severe mitral regurgitation” but fortunately there were no symptoms, which show or result in further damage. I often wonder what would have happened if the young medic hadn’t heard the murmur. Of course, I would have known nothing! I have been back to the young doctor’s practice and told him about my experience after he heard my murmur. I thanked him for his great hearing!
An oldish English doctor in Tokyo was a bit of a character. I told him one time that my vineyard-owning doctor in France had said about wine, “No more than a litre a day.” My Tokyo doctor said, “Sounds like commercial self-interest to me.”
Doctors in general for me are to give some reassurance that I’m all right. Of course, there have been times when they’ve had to come up with the right diagnosis and treatment for something needy. I would say I seek the help and advice of my doctor about 10 times a year. Of course, the past few years with my heart trouble, it’s been hugely more.
I like when my doctor hooks me up with a blood test, and as a vegetarian I know I need that kind of thing to tell me about my B12 or Iron or Zinc or whatever levels. I get a bit of what I call “glittery vision” but my optometrist called it “visual aura”. Then there’s my Dupuytrens Contracture, which makes it difficult trying to learn chords on the guitar – everyone needs something new in old age, so I thought I’d give it a go. I showed my doctor my crooked finger and she said an operation is possible for it. I have gone to the doctor many times about my stomach, a life-long dyspepsia. I take digestion tabs regularly and tend to be careful about my diet.
There was a burst vein in my John Thomas – that’s penis or “membrum virile” to a doctor. It went crimson like a stormy sunset! Looking at the sample I took in its little beaker thing, I said to my doc it’s the colour of rosé, the wine. We both said at the same time, “Not for drinking though!” What else have I had a need for medical attention? Many cases of flu, sore throats and hay fever. Oh, there’s an odd pressure point in my abdomen – my doctor said it was a hernia, could have an operation if it got worse, that was way over 10 years ago. I went for medical advice a couple of years ago about a swollen testicle (I called it a “bulbous bollock”). The doctor I saw said it wasn’t uncommon but better to see a urologist. He concurred with the doctor, also doing an ultrasound on my testes, declaring them all right. I was happy to pay the huge fee!
About a dozen years ago I got Plantar Fasciitis in my right foot, caused by walking too far in bad footwear. My doctor referred me to a podiatrist who gave me good treatment, especially an extra sole inside my shoe. It took more than a few months to fix.
Some five years ago I had a bout of shingles. Hellish painful round my waist, worse than Plantar, like someone gripping the skin tight and holding on. My doc at the time prescribed a good cream and pills, fixing it in a few days. Great doc!
I had a big scare a good few years ago. I had something the size of a golf ball under my arm, very worrying. Fortunately, after several visits to the doctor and a specialist, it turned out to be a septic cyst thing. It was caused by severe strain when I’d been doing a lot of ceiling cleaning and painting.
A thoughtful doc told me to try to think of myself as one of the “worried well”, advice I really liked because it told me that I was quite well, no need really to think something awful. Truth to tell, I had shown my lump to a doctor friend, a pain specialist, and he declared it quite rightly as non-cancerous. Quite a relief!
I think I have reasonable cause to say I’ve kept many a doctor on their mental toes and provided them with fair reward. I have found that simply booking a consultation can greatly help any malady or ailment I might have, so much anxiety being simply in the mind. I’m always worried that it’s possibly something worse, which a doctor would know about. I have been blessed with doctors who knew their stuff and got things right.
I’m often told by experts and others that I’m fine, that I should be glad to be so well, that I shouldn’t worry so much about how else I could be, and that it’s natural to have off days.
I have good friends, mainly from school years, who chose to study medicine, and then strangely wished they hadn’t, the physical and mental work of being a doctor not to their liking. It must be a tough job for sure, dealing with all kinds of ailments and people. I’ve often wondered how a doctor feels having to deliver very bad news. One of my friends had to retire early, becoming depressed in his General Practice work. He said he should have chosen something more arty and literary. Another friend said if he had his time over again, he would choose to study Astro Physics. Yet another, a GP, wanted to move into consultancy work but he said that consultants tended to stay on in it beyond retirement, so there were no vacancies. He eventually got into UK Public Health which suited him. I guess when you’re intelligent enough and can easily do school work, there are only a few vocations to suit you, and you have no idea what you’re in for. For sure, the necessary people skills, empathy and dealing with troubled minds aren’t in the qualifications for entering medical school.
My American doctor now for over five years is excellent, knowledgeable and very able at assessing and finding further help and specialist services. She’s also able to relate well with her friendly nature. She obtained for me an expert third opinion to help convince me that the operation on my heart defect was essential. I think organising extra help like that is really important for a GP to be able to do, as well as getting one’s malady right, knowing when and how to check on things, also giving kindly encouragement where applicable.