Do Doctors Get Better Care?

MRI: Unfortunately, so much reliance has been placed on this technology that simpler, less expensive, and just as effective means of physical diagnosis are often ignored. (Miguel Alvarez/AFP/Getty Images)

Do doctors get better medical care than the rest of the population? Today, patients frequently complain that doctors don’t spend enough time with them or never communicate after a diagnosis is made.

At a class reunion of Harvard Medical School graduates, I discovered that doctors who are often specialists themselves don’t always end up with adequate care from their colleagues.

Several of my former classmates had undergone surgery after seeking the best surgeons and hospitals available. It was uncanny how many had suffered bad results. But high on their list of complaints was the lack of empathy from colleagues.

One classmate had a long history of neck pain. Years earlier he had suffered a sudden blow to the head that had left him with a “pins and needles” feeling in the fingers of one hand for several months. The trauma set the stage for arthritis of the cervical spine and pain.

Eventually the neck pain increased to such an extent that it was interfering with daily activities. Like all physicians, he reluctantly consulted his family doctor, who, after an examination, recommended he see a neurosurgeon at a major university hospital.

An appointment was made. The neurosurgeon would see the doctor but only after a wait of six to nine months. No special treatment here. The doctor, not wanting to ask for favors, decided to wait and suffer in the meantime.

Nine months later, he was still waiting, so another referral request was made, and an appointment was granted. The office requested that the doctor bring an MRI report.

As a physician himself, the patient realized that in a university hospital, he would be seen initially by the medical resident in his final year of neurosurgical training. It was this physician who performed a thorough examination and also examined the MRI.

The MRI revealed cervical stenosis, a narrowing of the space occupied by the spinal cord causing pressure on the cord and resultant pain. He stated that since the cervical stenosis was not causing any muscle or sensory changes, an operation was not needed.

What happened next surprised the doctor-patient. The resident left to report his findings to the neurosurgeon and returned saying that he too agreed no treatment was required.

The doctor left never having seen the specialist to whom he had been referred after waiting for over nine months. No special treatment here! Not a single pinch of empathy for one of his own colleagues.

This should never occur in a university hospital or anywhere. I realize neurosurgeons are busy, but he should have taken a moment to say: “Doctor, I’m sorry you have this problem, but the findings show that surgery is not the best approach. I’d be pleased to see you again if the problem gets worse. Then the risk of an operation would be justifiable.”

This episode reminded me of the time President Franklin Delano Roosevelt delivered a complicated economic message to the U.S. Congress. Later, one of his aides was asked by the press, “Does the president fully understand the economic implications of this announcement?”

His aide thought for a moment and replied, “Possibly not, but Roosevelt knows how to be president.”

This neurosurgeon never learned how to be a doctor. It involves more than using a scalpel or examining an MRI. It means communication and a little empathy. As one Harvard professor said, “Caring for the patient means caring for the patient.”

One of my gray-haired classmates, a professor of surgery, was appalled at how quickly today’s doctors order an MRI when examination would often make the diagnosis. He constantly reminded his residents of this basic medical instruction.

Neither my classmates nor I imply that all of today’s doctors are lacking in empathy. But there’s a tendency to forget that communication with patients helps them more than most medicines. At least greeting and sympathizing with a referred patient is a good start.

We all wished that the neurosurgeon had had the opportunity to attend our final lecture at Harvard Medical School. A distinguished Hungarian professor gave the lecture and said, “Always make the patient feel as though he were the only pebble on the beach.”

Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto. His website is DocGiff.com He may be contacted at Info@docgiff.com