The most common complaint about physicians on the Internet is, “They didn't listen to me.”
By Dike Drummond, MD
HEALTH Others feel exactly the same way. You are sitting in the office and the doctor is physically present in the room, but not all there. Even worse is when the doctor doesn't try to understand what you are going through. Sometimes it can seem like they don't even care.
Most of us take for granted that we should be the center of our doctor's attention when we are face-to-face in the office. They are supposed to listen, care and empathize with our situation. That's what we pay them for. They are our medical expert and a powerful shoulder to lean on when we are in need.
However, there are invisible forces present on most office days that can block your doctor's ability to be a caring presence, turning you into the "runny nose in room three" from their perspective. It isn't fair and most of us would say it's not right. Yet these forces can explain why your doctor may not have been a very good listener today.
Distractions, Work Overload And Stress
You are one of dozens of patients this doctor is seeing today. They have dealt with a number of problems before they walked into your room and they know there are many more patients to see before they can head home to their family. They have dozens of loose ends in the form of test results that aren't back yet, patients not responding to treatment who are coming in for an urgent visit and much more.
Being a doctor is stressful. Continuously caring and being empathetic is an impossible expectation. When doctors are under stress, the first thing that goes is the ability to listen and care. Unfortunately, these are also the two most important things to you as the patient. There is even a name for this symptom of stress in healthcare: compassion fatigue. No one has an endless supply of compassion. When it is gone, the ability to listen often goes along with it.
Burnout is a direct result of the chronic stress of being a physician and it is much more common than you might realize. Studies have consistently shown symptomatic burnout in an average of one third of physicians on any given office day, worldwide, regardless of specialty.  In some studies the burnout rate is over 70%. It is an epidemic in medicine that is not widely acknowledged outside of the research studies. Your doctor may be suffering from burnout on this particular office day.
Burnout renders your doctor one of the walking wounded in our healthcare system. They are exhausted, cynical and their listening and compassion skills are offline. The same studies show burned-out doctors make more errors, provide lower quality care and their patients are less satisfied.
The Superhero Syndrome
In our physician training we learn to be superhuman. We work 120 hour weeks dealing with critically ill people always putting our own needs last. Doctors often feel guilty when we take time for ourselves and our lives often become very unbalanced. Recharging our batteries is not something we are taught — in fact it is frowned upon. So instead of noticing stress and burnout and taking a break, we do what we have always done — work even harder. We have never been taught how to get our needs met which leads to the high burnout rates above.
What You Can Do On Your Next Office Visit
The next time you are in the office and your doctor hurries into the room 30 minutes late — realize that it wouldn't be unusual for them to be stressed, too busy, verging on burnout, distracted and very challenged to listen and empathize with your concerns. I consider it a miracle that doctors manage to be as compassionate as they often are. No matter how your doctor seems on this day, here is something you can do to help them re-center. Sometimes even a superhero needs a little support.
Help Them Take A Big Breath
This little cue lets the doctor know you have some understanding.
Say hello. Ask your doctor to take a big breath with you and let go of everything else that might be going on in their day — you do the same — so that both of you can be fully present together right now. This little cue lets the doctor know you have some understanding of the pressure they are under and reactivates their compassion and ability to listen.
You might feel this is an outrage — that it is the doctor's job to be a compassionate listener no matter what. I also know what it's like to be on the other side of your office visit. I assure you, this will make a huge difference to your doctor. It would not surprise me if they thank you and continue to remember your act of kindness for the rest of the day. They will love the fact that you noticed and cared — the very same way you appreciate their caring and concern. And you will have a much better office visit.
That breath will clear the air and allow them to focus all of their attention on you. You will be able to connect in a way that would have been impossible without it. They will listen. Try it next time and see.
About The Author
Dike Drummond is a family physician who provides burnout prevention and treatment services for healthcare professionals at his site, The Happy MD. Follow on Twitter at @TheHappyMD.
- How is doctor burnout impacting patients? minnesota.publicradio.org