Doctor Paper

  1. What reflections do you have on what you learned or what you now think about the experience of being a patient after watching the movie? From the second you walk into a hospital to when you leave, all the steps almost seem like an assembly line.

Check-in, paperwork, diagnostics, test results, pre-operation, operation, postoperation and check-out. Each step of the way there are different people and must reintroduce yourself repeatedly. Most of the people in a hospital are dealing with hundreds of people a day, and unless they are being trained on hospitality and how to treat patients, most of these workers get tired of being repetitive to hundreds of people a day. They start to become robotic and rush you to get to the next patient as soon as possible. Thus, every interaction a patient has with a staff member would make them feel as if they are just another number to check off in the eyes of the staff member. I have always understood this considering I have been in and out of the hospital more times than I can count from when I was a child. I had severe asthma and would be rushed to the ER when my nebulizer would not calm down my labored breathing. Especially as a child, you feel as if there are big people all around you and you don’t know what is going on since they would speak to your parents and not you. As I got older, I always tried to find doctors that were in private practices for me to get that one-on-one welcoming feeling from my doctor instead of feeling like another number when I go to the hospital. Most of my doctors now are in a small private practice, although I understand that they might not have all the most up to date technology that a hospital would, I would prefer to have a doctor who engages in

  1. Please note specific examples of how physicians treated patients in the movie (how the main character, Dr. Jack McKee was treated and how he treated other patients) – in light of what you now know about patient communication.

Another example, Dr. McKee had noticed a progressing dry cough for the past few months and finally decided to see a throat specialist. When the throat doctor came into the examination room, Dr. McKee tried to be personable with the doctor and the doctor came off very distant and non-personal with Dr. McKee. It was imminent that she had a strict clinical-based interaction with Dr. McKee and made the interaction cold and uncaring. This was ironic because he did not expect to have this type of behavior given to him. After her examination of Dr. McKee’s throat, she simply said, “Doctor you have a growth.” And just stopped speaking after. She followed by showing him where it was located and the test’s he is going to have to take in order to get a better prognosis of what the growth might contain. There was absolutely no patient-based interaction within this entire scene, and it seemed so uncaring that it seemed fake. However, I know that the patient-centered approach has only been taught within the past few decades, therefore I’m sure this is exactly how many people would practice medicine. There did not seem to be a need for being emotionally available to your patient after telling them their diagnoses. When Dr. McKee finally had his biopsy, his throat doctor said to him after, “your tumor is malignant.” As before followed up with his two options of radiation or surgical removal. She was very cold in her delivery and Dr. McKee tried to lighten the mood by making a joke and she snapped at him saying “Dr. McKee, you have cancer!” He chose radiation and she said okay and left the room right after. Another example of a poor patient-centered interaction.

  1. In the last scene where Dr. McKee has an exercise for his interns where they have to be in the role of patients:

a. What do you think they would learn from the exercise? I believe they would understand how it feels to be a patient in a hospital and will get to experience the stressors that patients go through daily. Patients must deal with numerous amounts of people a day and are seen as another patient with another diagnosis. Their interactions with patients have consequences that could be detrimental or harmless. This might change their outlook on how to practice in terms of their patient approach.

b. How do you think it might make them talk to patients or treat patients differently? They will understand the point of treating each patient as an individual rather than another case. For example, one of the interns had called a patient “terminal” instead of their name and Dr. McKee scolded him in front of all the interns that if he ever called a patient as “terminal” again, that is where he would see his future. Dr. McKee was making the point that medical providers should give their patients respect and dignity when it comes to their health. The bare minimum is to call a patient by their name instead of their diagnosis name such as “terminal”.

  1. Give some examples about how Dr. McKee’s approach was “Clinician-Centered” in the beginning and “Patient-Centered” after he had been treated for his cancer.

During the beginning of the movie, Dr. McKee seemed very relaxed and unprofessional when it came to showing respect towards the patients he was dealing with in terms of his sarcastic remarks and joking answers. When he was asked to consult on another patient during his surgery, the doctor he was working with was the complete opposite in terms of mannerisms towards his patient. Although the patient was asleep, the doctor spoke to the patient about what was happening throughout the procedure as if he cared for the patient. It was said that he believes that people can hear their surroundings when they are under anesthesia which is why he speaks to them. This was a juxtaposition in terms of difference in character and what Dr. McKee lacked in his approach in patient care. Another example was during Dr. McKee’s first conscious patient interaction, he was with a patient who was there to get her staples removed from her chest where her incision was. The patient started speaking about her husband’s worries of the scar being too noticeable and looked to Dr. McKee for comfort. Her initial body language showed that she was already timid and nervous to ask her question, but she went out of her comfort zone to ask the doctor her question because she thought that it was important. Instead, he said, “tell your husband you have a playboy’s center shot and you have the staple marks to prove it” and proceeded to laugh. His remark was inappropriate when all the patient was asking for was some sympathy and reassurance that her scar would eventually get better. The patient then become completely closed off and quiet after his remark, making her feel as if she could no longer voice her concerns to her own doctor. Although he did add humor into his patient interaction, it was not appropriate, therefore this interaction was solely clinician centered. This type of interaction happens very often between patients and doctors which is why there are so many people who do not trust doctors. One patient interaction is all it takes for a patient to no longer want treatment, not want to be seen by that doctor again or not want to go to the doctors ever again. Therefore, it is so important to remember that your patient-centered interactions can evidently be more important than your diagnosis. Dr. McKee finally understood how important it was to feel welcomed by your doctor when he was being examined by Dr. Abbot, the initial throat doctor. She was very closed off and inattentive to her patient when diagnosing Dr. McKee with a malignant growth in his larynx. This is when he realized that his approach to patients had been off all along. At the end of the movie, Dr. McKee had a patient who was getting ready to have a heart transplant. He entered the exam room to speak to the patient before he went to be operated on and his family was worried that his new heart would not be a “kind heart”. Dr. McKee entertained this idea because it was important to the patient’s family and said that he was sure that it would be a kind heart. He would not have cared enough to even answer such questions before his diagnosis and now he understands how important it is to be included into your patient’s life so that you can make decisions together as a team. This is where he finally implemented a patient-centered technique within his practice of medicine.

  1. It is said that health care providers sometimes spend too much time treating the disease and not enough time treating the patient. How is that idea illustrated in this film?

This film illustrated that medical providers are taught how to be a good at diagnosing humans, rather than learning how to treat a patient. The point of the film was to show that many doctors become robotic in their studies that they forget to incorporate effective intrapersonal communication between themselves and the patient. Evidently losing the trust of their patient and not feeling as if they can voice their opinions with their medical providers. Patients could have one bad interaction with a doctor and assume that this is how all doctors’ acts. The point of a medical provider is to help treat and educate our patients which we can’t do either of if the patient does not come back for their next appointment.