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Advice to New Doctors Still Valid For Current Doctors

The British Medical Journal compiled a list of suggestions given to new medical students at a new medical school in England. Sage advice for many practicing physicians. The following is a small sample of the many great recommendations in this article:

All doctors and health systems purport to put patients first, but ample evidence shows that it often doesn't feel that way to patients. They regularly feel like cases rather than people, and what is important to patients is often different from what is important to doctors. For doctors Parkinson's disease is mostly above the neck, something to do with the substantia nigra. For patients it's mostly below the waist: Can I get my knickers on? Will I be continent? This difference of view is to be expected, but the best doctors are those who can begin to see the world as the patient sees it.

Such a state is achieved mostly by active listening. It's one of the maxims of medicine that "listen to the patient and he or she will tell you the diagnosis." But the maxim is often ignored. Similarly the fashion is to make decisions with the patient, not for the patient, but again this is not the reality of everyday practice in most countries. Evidence shows that genuine partnership with patients produces better outcomes and greater satisfaction for both patient and doctor, but this may be hard to achieve in the middle of an exhausting night with a sick patient who doesn't speak your language and doesn't even seem "grateful."

Never forget the value of learning not only for chasing after wisdom but also because it may be the ultimate balm. The author T. H. White expresses it beautifully, and I make no apologies for repeating his words: learning "is the only thing which the mind can never exhaust, never alienate, never be tortured by, never fear or distrust, and never dream of regretting."

Britisih Medical Journal December 20, 2003;327:1430-1433 Free Journal Article

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