DURING THE PAST FIVE YEARS, I lost four doctors: my primary care doctor, neurologist, ophthalmologist, and dentist.
I was pretty bummed out, not because I had to find new healthcare professionals, but because my new doctors and I had to get to know each other. I needed to build a relationship with new people so that they knew me and what was happening in my life to get the best advice to stay as healthy as I could. These would be critically important relationships in my life.
Maybe I was obsessing about this “getting to know me” part of my new doctors, so I checked with a doctor to see what they thought about it. I asked my friend, Dr. Cindy Ripsin, MD, about the doctor-patient relationship. She is board certified in Family Medicine at two Coastal Health and Wellness Clinics in Texas—Galveston and Texas City. Her patients range from birth to the final stages of life. The clinics care for the underserved in the community. She sees it all.
Dr. Ripsin believes that she can best help patients when they work together as partners in their healthcare. When patients take the time to give her constructive feedback, it always improves their healthcare experience.
She adds, “Physicians used to be educated in a way that made us believe we were the ‘god’ in the room. Over time, we realized that patients need to have a say in every aspect of their care, even if the physician does not always agree with them. This does not mean, however, that patients should be able to dictate every aspect of their care. Sometimes patients want treatments or medications that are not safe or have not been shown to be effective. As a physician, it is my responsibility to openly discuss with patients if their treatment requests or demands are not safe.”
Dr. Ripsin believes telling patients about safety in healthcare is part of her responsibility to never waiver from her Hippocratic oath “to do no harm.”
A patient is basically in a relationship with their doctor. When a patient tells their doctor about their aches and pains, medication effectiveness, or sleeping habits, that is important. What is also very important are things woven right into their lives that can challenge their overall health. Things like job loss, death of a family member, or a broken relationship can be critical in assessing where symptoms originate.
Dr. Ripsin reflects that many patients say, “My doctor does not really listen when I talk, and doesn’t understand me.”
Patients are very appreciative when their doctors look at them (some patients call it “face time”) instead of inserting data into their iPads. When a doctor allows a patient to talk and responds to them with questions or comments that show the patient has been heard, it can be a true partnership in healthcare.
“Having a healthy relationship with your doctor has been repeatedly shown to enhance healthcare. Patients who are partners with their doctors can have better health and might even live longer than those who do not. When the time spent in the medical visit is an honest and open conversation between the patient and the physician, decisions about aspects of healthcare that really matter can be made,” she says.
Careful doctor-patient listening during an appointment can be a challenge in today’s healthcare culture. Time constraints can put pressure on both patient and physician, so a structure for the office visit time can help. If a patient visits their doctor to address their diabetes, or blood pressure and high cholesterol, and is more concerned about their sore shoulder or about suddenly experiencing panic attacks, both the patient and doctor need to decide together what needs to be managed first at that visit. Sometimes the best way to handle the present office concerns might change addressing what the patient was originally scheduled for (diabetes, etc.) and might dictate another appointment to continue to manage what cannot be done on that day.
Dr. Ripsin believes that at the beginning of their visit, doctors may need to point out to patients what can be managed at the appointment and what needs to be addressed at another visit. When a patient’s concerns are addressed, they can develop a trust that their doctor is listening and helping them manage their health.
In this digital age, health systems often speak of the efficiency of electronic patient records. It is true that many patients appreciate being able to look up their charts online, to see what their doctors prescribed or said about their healing process.
Digital records are efficient, but Dr. Ripsin explains, ”One of the saddest aspects of the evolution of medicine is that sometimes it is the patients that are the ‘corner that is cut’ in order to do everything that we are expected to do within a single office visit, which includes documenting within an electronic health record. The myth of the electronic health record is that it makes us more efficient. In fact, it is far less efficient and it takes physicians much longer to document a visit now than it ever did before. However, the electronic health record is much, much safer than handwritten documentation, so it is a vital and essential part of healthcare.”
Many physicians have burned out and left the profession rather than continue to struggle with trying to balance these seemingly competing interests, but Dr. Cindy Ripsin is staying right where she is—in medicine.
“For me, the key to avoiding burnout is to constantly remind myself that the patient is at the center of what I do for a living. I work hard to develop the relationship with the patient, and then outside of the exam time, I work hard to efficiently manage the electronic health record so it does not encroach upon the time I spend with patients. A difficult balance, but very worthwhile in the long run,” she says.
Can you talk? Do your part to be a good patient partner. Prepare for your visit by thinking about what is going on in your life and writing down questions or concerns. Be honest and realistic about what can be done during your visit. Understand that what you tell your doctor can help make the most out of your medical visit.
Sister Karen Zielinski is the Director of Canticle Studio. Canticle Studio is a part of the Sisters of St. Francis of Sylvania, OH’s overall advancement effort and has a mission of being a creative center where artists generate works, products, and services in harmony with the mission of the Sisters St. Francis. She can be reached at kzielins@sistersosf.org or 419-824-3543.
