Rule 282: Learn to get the full attention of your patients.
And learn to give them YOUR full attention.
This rule comes from Dr. Clifton Meador’s A Little Book of Doctors’ Rules, a book given to me early in my med school career. What follows is a deep dive into Dr. Meador’s 282nd rule: Learn to get the full attention of your patients and learn to give them yours.
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Attention is important because it’s a valuable resource that functions like currency. Much like money, where you spend your attention betrays what you find meaningful or worthwhile. Attention directs your intention. Applied to the world of medicine, this is where you get Rule 282. But first, an important distinction.
Attention, in and of itself, is less important than the act of being attentive. An analogy for you – money is less important compared to what you do with it. Reckless spending on unnecessary doodads is less attractive than being frugal, setting goals and spending conscientiously. The same is true for attention. If I let just anyone or anything direct my attention, then I act in a way that devalues it and, by extension, myself. So…by being attentive, I’m able to spend wisely.
Why is this important? If attention is something people can spend between themselves, then being attentive with patients is a demonstrable way of being a supporting and respectful doc. Put differently – you’re investing in them and your doctor-patient relationship. This is important because it combats the unfortunate, but oftentimes necessary, sterilized environment of the medical world. Hospitals aren’t usually built to be warm and inviting, they are built with the sole objective of curing disease (or at least, in an ideal world that’s their sole objective). This design emphasizes efficiency but can also come off as cold. Spending time and attention on patients pushes back against this intimidating environment and acknowledges their humanity with warmth.
Acting in this way has the added benefit of leading by example. For instance, as a patient it’s much easier to be fully present during my appointment if my doctor is first. In other words, I am a patient looking for guidance and answers from an “expert;” therefore, my doctor is leading me. If my doc sets a good example, then I as a patient will be much more likely to reciprocate and follow their lead. The more I write about this, the more I realize this is all about the golden rule: treat others as you would like to be treated. Do I want my patient’s undivided attention? Yeah. Then I have to give them my undivided attention. I can’t have my cake and eat it, too…
There’s another reason why being attentive is important – it helps you focus. This is important, in the context of medicine, because you can pick up on little details that would otherwise go unnoticed. Let’s look at an example:
A patient comes in with uncontrolled blood sugar. You just started them on insulin, but it’s not working, and their sugars remain high. You’re going through your differential diagnosis (list of things that could be causing your patient’s symptoms) all the way down to the rarer causes. But you’re present in the moment and notice that their shoes have holes in them. Their pants are subtly stained with dried splotches of muck and mud. They’re making less eye contact with you than usual. That’s when it hits you – you ask him, “How are things at home?” Turns out his fridge broke down just 2 days after your last visit and he can’t store his insulin. Lacking the funds needed for repair, shame got the better of him and he neglected to tell you about it.
Stuff like this happens more often than you’d think.
Why didn’t he just tell you what happened? Why try and hide it? These are fair questions that get at the essence of this rule. It’s not a patient’s responsibility to trust you outright, it’s your responsibility as the provider to act in a way that is worthy of their trust. Being attentive is a big part of that equation: it helps build trust.
So what’s the moral here? Attention is a precious resource - spend it where you should.
As always, thanks again to Dr. Meador.
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- Tyler
I love this rule and your article - a doctor/patient relationship goes both ways of which you have a great understanding. Keep it up!