✊ write easy reader What Doctors Feel: How Emotions Affect the Practice of Medicine eBook: Danielle Ofri: Amazon.fr: Amazon Media EU S.à r.l. ̱ Ebook By Danielle Ofri ᾨ IntroductionWhy Doctors Act That WayThe experiences of medical training and the hospital world have been extensively documented in books, television, and film Some of this has been probing and incisive, and some has been entertaining nonsense Much has been written about what doctors do and how they frame their thoughts But the emotional side of medicinethe parts that are less rational, less amenable to systematic interventionhas not been examined as thoroughly, yet it may be at least as important The public remains both fascinated and anxious about the medical worlda world with which everyone must eventually interact Within this fascination is a frustration that the health care system does not function as ideally as people would like Despite societal pressures, legislative reforms, and legal wrangling, doctors dont always live up to these ideals I hope to delve beneath the cerebral side of medicine to see what actually makes MDs tick One might reasonably say, I dont give a damn how my doctor feels as long as she gets me better In straightforward medical cases, this line of thinking is probably valid Doctors who are angry, nervous, jealous, burned out, terrified, or ashamed can usually still treat bronchitis or ankle sprains competently The problems arise when clinical situations are convoluted, unyielding, or overlaid with unexpected complications, medical errors, or psychological components This is where factors other than clinical competency come into play At this juncture in our societys history, nearly every patientat least those in the developed worldcan have access to the same fund of medical knowledge that doctors work from Anyone can search WebMD for basic information or PubMed for the latest research Medical textbooks and journals are available online The relevant issue the one that has the practical impact on the patientis how doctors use that knowledge There has been a steady stream of research into how doctors think In his insightful and practically titled book How Doctors Think, Jerome Groopman explored the various styles and strategies that doctors use to guide diagnosis and treatment, pointing out the flaws and strengths along the way He studied the cognitive processes that doctors use and observed that emotions can strongly influence these thought patterns, sometimes in ways that gravely damage our patients Most medical errors are mistakes in thinking, Groopman writes And part of what causes these cognitive errors is our inner feelings, feelings we do not readily admit to and often dont even recognize.1 Research bears this out Positive emotions tend to be associated with a global view of a situation the forest and flexibility in problem solving Negative emotions tend to diminish the importance of the bigger picture in favor of the smaller details the trees In cognitive psychology studies, subjects with negative emotions are prone to anchoring biasthat is, latching on to a single detail at the expense of others Anchoring bias is a potent source of diagnostic error, causing doctors to stick with an initial impression and avoid considering conflicting data Subjects with positive emotions are also prone to bias they are likely to succumb to attribution bias In medicine, this is the tendency to attribute a disease to who the patient is a drug user, say rather than what the situation is exposure to bacteria, for example This is not to say that positive emotions are better or worse than negative emotionsboth are part of the normal human spectrum But if you consider the range of cognitive territory that doctors traverse with their patientsgenetic testing, ordinary screenings, invasive procedures, ICU monitoring, and end of life decisionsyou can appreciate how the final outcomes can be strongly influenced by a doctors emotional state Neuroscientist Antonio Damasio describes emotions as the continuous musical line of our minds, the unstoppable humming.3 This basso continuo thrums along while doctors make a steady stream of conscious medical decisions How this underlying bass line affects our actions as doctorsand the net effect on our patients and on doctors when we ourselves become patients is what intrigues me By now, even the most hard core, old school doctors recognize that emotions are present in medicine at every level, but typically this is lumped in with the catch all of stress or fatigue, with the unspoken assumption that with enough self discipline, physicians can corral and master these irritants The emotional layers in medicine, however, are far nuanced and pervasive than we may like to believe In fact, they can often be the dominant players in medical decision making, handily overshadowing evidenced based medicine, clinical algorithms, quality control measures, even medical experience And this can occur without anyones conscious awareness It could easily be argued that doctors are no emotionally complex than accountants, plumbers, or the cable repair guy, but the net result of doctors behaviorlogical, emotional, irrational, or otherwise can have life and death consequences for patients, which is to say, for all of us We all want excellent medical care for ourselves and our families, and wed like to assume that the best care comes from the doctors with the best training, or the most experience, or the best U.S News World Report rating However, the myriad effects of emotional underpinnings can confound all of these factors Despite this, the conventional stereotype that doctors are fairly emotionless continues to maintain its hold Many trace this back to the eminent Canadian physician Sir William Osler, often considered the father of modern medicine for such revolutionary ideas as whisking medical students out of the staid classroom and bringing them to the bedside to learn medicine by examining actual patients The current educational system of clinical clerkships and residency training is largely attributed to Osler, as are hundreds of snappy quotations His continuing influence is apparent in the scores of diseases, endless libraries, and numerous medical buildings, hospital wings, societies,and awards that bear his name On May 1, 1889, Dr Osler stood before the graduating medical class at the University of Pennsylvania and delivered a valedictory and now canonicalspeech entitled Aequanimitas.4 He stressed to these fledgling doctors that a certain measure of insensibility is not only an advantage, but a positive necessity in the exercise of a calm judgment While Osler may not have created these attitudes, he neatly encapsulated the general feeling about how doctors should behave Though he did warn against hardening the human heart, the stereotype of the detached, coolheaded physician springs from this idea of equanimity Popular culture has embodied this Television doctors from Ben Casey to Gregory House are detached from their patients, lauded for their technological and diagnostic acumen Even the selflessly idealist doctors in Arrowsmith, Middlemarch, and Cutting for Stone and the bitingly sarcastic doctors in M A S H, House of God, and Scrubs maintain an equanimitous distance from their patients Every hospital dutifully includes the word compassion somewhere in its mission statement Every medical school rhapsodizes about the ideals of caring But the often unspoken and sometimes spoken message in the real life trenches of medical training is that doctors shouldnt get too emotionally involved with their patients Emotions cloud judgment, students are told Any component of a curriculum upon which interns slap the touchy feely label is doomed in terms of attendance Hyperefficient, technically savvy medical care is still prized over all else But no matter how its portrayed, and no matter how many high tech tools enter the picture, the doctor patient interaction is still primarily a human one And when humans connect, emotions by necessity weave an underlying network The most distant, aloof doctor is subject to the same flood of emotions as the most touchy feely one Emotions are in the air just as oxygen is But how we doctors chooseor choose notto notice and process these emotions varies greatly And it is the patient at the other end of the relationship who is affected most by this variability This book is intended to shed light on the vast emotional vocabulary of medicine and how it affects the practice of medicine at all levels Hopefully, the next time we find ourselves in a patient gown, well better understand the workings of those who care for us Cognition and emotion are inseparable, Groopman observes The two mix in every encounter with every patient In some scenarios, this mix is highly beneficial to patients In others, it can be calamitous Understanding the positive and negative influence of emotions in the doctor patient interaction is a crucial element in maximizing the quality of medical care Every patient deserves the best possible care that doctors can offer Learning to recognize and navigate the emotional subtexts is a critical tool on both sides of the exam table.Taut, vivid prose She writes for a lay audience with a practiced hand New York Times In her lucid and passionate explanations of the important role that emotions play in the practice of medicine and in healing and health, Danielle Ofri tells stories of great importance to both doctors and patients Perri Klass, author of Treatment Kind and Fair An invaluable guide for doctors and patients Kirkus ReviewsInsightful and invigoratingmakes the case that its better for patients if a physicians emotional compass needle points in a positive direction Booklist, starred reviewA fascinating journey into the heart and mind of a physician struggling to do the best for her patients while navigating an imperfect health care system Boston Globe Ofrigives voice and color to the heartbreak, stress, and joy that attends medical practice Library Journal A fabulous read Greater Good Essential reading in Medical HumanitiesShe weaves together personal anecdotes and medical learning in a compelling account of her medical decisions and reflections Highly recommended.Sara van den Berg, Professor of English, Saint Louis University Dr Ofri s real life experiences can be incorporated into a variety of health science curricula bringing course theory together with practical application Readers gain critical insight into why applying theory in the practice of medicine requires empathy for the physicians.Christine Whittrock, Department of Pharmaceutical Sciences, Temple University Part of medical education now is not only core competencies from a factual standpoint but also a social standpoint Dr Ofri has a way of communicating those lessons in a clear a cogent and very personal fashion.Beth Dollinger M.D., Arnot Ogden Medical Center The perfect book for my teaching on the subject of lack of empathy in medical school students.James Asa Shield, Jr., MD, Professor, Chairman, Department of Psychiatry, Virginia Commonwealth University Some Doctors Say to Stop Antibiotics When You Feel Better A group of doctors say it s time drop the complete course mantra for antibiotics, which they contributes drug resistance When Rural NC Health Clinic Closes, Patients and Leoneda Inge reports on challenges feel when free health clinics close in rural North Carolina It early afternoon a recent Tuesday Dr Francis Aniekwensi is preparing Ethical guidance GMC gmc uk Our ethical guidance, where we set out principles good medical practice describe professional values, knowledge, skills behaviours expected all working UK Pain babies Wikipedia Pain babies, whether pain, has been large subject debate within profession centuriesPrior late nineteenth century was generally considered that hurt easily than adults only last quarter th scientific techniques 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determined capacity, value, number relatively backyard absolute implication carrying City Beacon Press, Education Research Health written five books about medicine, special focus relationship danielleofri Twitter latest Tweets Physician Writes NYTimes Newest Hear, Editor BLReview Ever strugglng cello student York, NY slate Well Blog Today spend computer filling endless electronic record come define modern transaction move exam table, everything changes TEDMED Speaker Ofri attending Associate Professor powerful, against grain case professionals fundamentally avoid something crucial could Moth Art Craft Storytelling Hospital, oldest public founder Chief Literary Review, first literary journal setting crisis confidence while night Author Goodreads About started school, had no idea become writer d completed PhD biochemistry endorphin rece Dr Book Appointment NY internal specialist practicing years graduated Univ Sch Of Med specializes Writer profile LinkedIn, largest community jobs listed 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- What Doctors Feel: How Emotions Affect the Practice of Medicine eBook: Danielle Ofri: Amazon.fr: Amazon Media EU S.à r.l.
- Format Kindle
- 233 pages
- Danielle Ofri
- 21 July 2017 Danielle Ofri