Rule 17: Some people have fast brains, others have slow brains.
Adjust your thinking to the pace of the patient.
This rule comes from Dr. Clifton Meador’s A Little Book of Doctors’ Rules, a book I received early in med school. What follows is an examination of Dr. Meador’s 17th rule: Some people have fast brains, others have slow brains. Adjust your thinking to the pace of the patient.
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This rule is about communication, teamwork, and humility. Let’s dive in…
What’s the goal of a doctor’s visit? Problem solving. A patient has a concern and relies on their doctor to provide a solution. The doc can be relied upon because they have knowledge and experience that their patient does not possess. It’s an easy “input/output” – a patient has a problem and the doc has the solution. However, the solution is inadequate IF the patient doesn’t understand it. This is where this rule comes in.
An effective doctor has effective solutions and treatments. A treatment can only be effective if the patient understands (a) what happened to cause the problem they are experiencing and (b) how the treatment will fix it. This begs the question - what makes a treatment effective? Answer: both the treatment itself (anything from a necessary medication or surgery to helping your patient change a behavior) and the execution of that treatment.
This execution is the most obvious example of the teamwork between doctor and patient. It’s also a great example of thinking, speaking, and working at your patients’ pace. For instance:
Say you give metformin to a newly diagnosed type 2 diabetic. There are many possible outcomes other than “the patient gets better and lives happily ever after.” They…
… may not take the medication because they come away from the encounter not fully understanding how to take it appropriately.
… may not comprehend the severity or extent of their diabetes and, consequently, not prioritize their new medication.
… may not fully understand how they developed diabetes in the first place and continue habits that contribute to the progression of their disease.
And on and on… All these outcomes, where the execution of the treatment is lacking, fall under the doctor’s purview because they can be fixed with sound communication. Like a handyman without a hammer - a doctor who cannot communicate cannot be effective.
So how to execute? This brings me to my next point - a large part of doctoring is teaching: e.g., relating the “how’s” and “why’s” of both the issue and treatment, and making sure your patient understands to the fullest extent of their abilities. Therefore, it stands to reason that to be an effective doctor you must be a great teacher.
Here’s a fun fact for you, dear reader: the word “doctor” comes from the Latin “docere” which means “to teach.”
Great teachers speak to the level of their students or, put another way, “think at their pace.” These teachers also make difficult concepts relatable to their audience. They’re able to accomplish this because they are in the unique position of having been students once before. The same principle holds true for doctors. They have the privilege of practicing medicine, but also had the experience of NOT practicing it. To state the obvious, the vast majority of patients have only ever experienced NOT practicing medicine and NOT being doctors. It’s important that doctors remember what it was like before entering the medical world. Doing so makes it easier to sufficiently convey hard-won medical knowledge.
To be effective you must move at your patient’s pace. To move at their pace it’s best to remember where you came from (before you became a doctor), which is an act rooted in humility.
So you want to be a good doc? Communicate…and stay humble.
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- Tyler
Excellent!