Category Archives: the practice of medicine

the art and skill of listening

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Listening

The skill to listen and to give ourselves the time/space to reflect on what we observe is central to a good life. Quality listening allows personal and professional growth, sustains our relationships and promotes learning. Without the ability to listen, we place ourselves out of range of others, and thus unable to gain valuable insights from them, or to provide help and answer needs. For a fulfilling personal and professional life we must acquire the skill of honed, effective listening.

Although most of us recognize the value of listening, human nature possesses a strong impulse to share, and, even, to be first to speak and to voice our opinion! Despite both a need and desire to listen, humans have a nearly irrepressible urge to interrupt in order to share their own point. Such impulses can, and do, crowd out the other personsʼ words, insights and desires whereby they may never be heard.

Listening in Healthcare

Recently the topic of listening has been getting a major public airing in discussions regarding doctor/patient communications. Continue reading →

slow medicine – not can we afford it, but how can we not?

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The_Doctor_Luke_FildesBernadette Keefe MD

The Unease

Over the past few decades there has been an increasing disquiet among doctors and patients. Prior to the late 1970s (pre CT/MRI era) other than basic blood work and plain xrays, there was little in the way of testing for disease. However physicians were well equipped with a robust heritage of  patient bedside history-taking and examination skills. Adept physicians in elucidating a pertinent historical record and performing patient examinations were brilliant diagnosticians. Lavishly written patient narratives and exquisite physical examinations filled voluminous charts.

The late 1970s ushered in organized medicine, HMOs, regulations and abundant technological and medical advances. This potent combination resulted in a tremendous escalation in the volume and pace of healthcare. Physicians, once loved for their bedside manner and comfort (1950’s-1960’s) found, from 1980s-present that they were so rushed and burnt out they had little empathy to spare. Patients picked up on this and, coupled with little time to ask questions and (now) electronic medical records consuming their doctor’s attention, stopped feeling cared for. They stifled their questions and stopped buying into the therapies being proposed for them. (Note: Perceived lack of empathy has been shown to adversely affect clinical outcomes.)

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