Do Doctors Need to Love Patients? | Rheumatoid Arthritis Warrior

Do Doctors Need to Love Patients?

The most admired leaders of our country have been the ones who trusted us, valued us, and actually loved us. President Reagan called America a “shining city upon a hill,” a biblical reference to the country’s position of service to the world; and in his final goodbye letter he reminded us that it is still dawn in America. Think of President Kennedy’s call for us to rise up and serve others; he knew we could and we would. Even Reverend Martin Luther King’s I have a dream speech conveys his expectation that we are up to the task.

Motivated by love

I’ve been pondering about whether there is a need for this kind of confident appreciation in medicine. By love, I do not mean that doctors need to have their patients over for dinner or give them physical affection. Rather, I’m thinking that they need to have passion for patients as a group and for our success as individuals.

  • Doctors who care passionately for patients would believe in our rights and abilities to handle our information. They would believe us when we claim to have symptoms and trust us if say we have side effects. They would work hard alongside of us to find ways to make our lives as healthy and comfortable as possible.
  • Doctors who love patients would not be biased according to negative prejudices of patients with chronic disease, assuming we’re seeking more pain drugs than we need or exaggerating symptoms to obtain disability benefits or some kind of “secondary gain.” They would not scoff at or minimize our symptoms because that is unkind. They wouldn’t write things in our charts that they know we would call inaccurate.

All of these positive and negative actions could be motivated by love, more than by fear of legal complaints or bad publicity. Operating from a position of fear or suspicion can interfere with the ability to be a trusted helper. But operating from a position of love makes a doctor a healer.

Can medical students be taught to reach beyond a paternalistic approach as a model of caring for patients and actually respect patients and trust patients’ ability to contribute?

Would love have an effect?

Bear and Amelia tha alpacaI clearly remember saying that it didn’t matter that Dr. Smart Rheum (Bone Scan) wasn’t the warm and fuzzy type. I was satisfied that I found what I really needed: a rheumatologist who didn’t waste precious time telling me I’m not sick anymore because my labs are improved; that I’m in remission no matter what my symptoms are. This doctor never tried to talk me out of my RA symptoms or blame them on some syndrome or other.

From our side we gave gratitude, respect, and cooperation …and paid all our bills. I would have gladly had dinner, too.

However, in the end, when I needed help, Dave deBronkart put it correctly: my well being did not turn out to be their priority. I kind of suspected that for a long time. But when you have RA, you really need a doctor, so I compromised. And I’ll probably do it again.

Meanwhile, this is my front porch. And I invite you to sit with me and wonder about what might be best. And what might be possible. Should doctors love patients?

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Kelly O'Neill Young

Kelly O'Neill (formerly Kelly Young) has worked over 10 years as an advocate helping patients to be better informed and have a greater voice in their healthcare. She is the author of the best-selling book Rheumatoid Arthritis Unmasked: 10 Dangers of Rheumatoid Disease. Kelly received national acknowledgement with the 2011 WebMD Health Hero award. She is the president of the Rheumatoid Patient Foundation. Through her writing and speaking, she builds a more accurate awareness of rheumatoid disease (RD) aka rheumatoid arthritis (RA) geared toward the public and medical community; creates ways to empower patients to advocate for improved diagnosis and treatment; and brings recognition and visibility to the RA patient journey. In addition to RA Warrior, she writes periodically for newsletters, magazines, and websites. There are over 60,000 connections of her highly interactive Facebook page. You can also connect with Kelly by on Twitter or YouTube, or LinkedIn. She created the hashtag: #rheum. Kelly is a mother of five, longtime home-schooler, NASA enthusiast, and NFL fan. She has lived over thirteen years with unrelenting RD. See also https:/rawarrior.com/kelly-young-press/

20 thoughts on “Do Doctors Need to Love Patients?

  • August 29, 2011 at 8:23 am
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    The best doctors do love their patients though maybe the better word would be are compassionate toward their patients or maybe concerned about their patients. When doctors don’t care or don’t respect their patients has human beings they won’t be able to give them adequate care. it will be cold and clinical and leave a bad taste in the patient’s mouth, even promote the shame a patient with chronic pain feels (though shouldn’t) because of the pain she or he is in.

    The best servants for the people are the ones who care for those who they are serving: teachers, doctors, lawyers, anyone who works with people and whose job it is to help them or equip them in some way.

    Sadly, we are losing this in so many areas of life. May we be the kind of people who do love those who God brings into our lives.

    Reply
    • August 29, 2011 at 8:56 am
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      Thanks, Jane. Good points. I know I wrote this as an American, but last night I also thought how much I have always perceived that the Queen loves Britain. When you think of it, good teachers “love” kids. Even great football players “love” fans. There is some passion required to good medicine.

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      • August 29, 2011 at 10:01 am
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        It is good to feel like you are a person to your Doctor and not just a patient number. It would be a wonderful world if all Doctors really cared about helping their patients and all teachers really cared about reaching and teaching their students. But on the other side I think your burn out rate would be higher because it’s hard to care and not be able to find the right answers. It also takes more time and effort so you can only see fewer patients and there is already a shortage of Drs. to treat RA patients. Then you have patients that may be non compliant and not put in their effort to improving their health just as you have students who don’t want to learn and won’t put in their effort and you end up feeling like you are banging your head on the brick wall.

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  • August 29, 2011 at 10:09 am
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    Every day, doctors help patients go from sickness to health. And if there is no cure, there is typically a drug or maintenance tool to manage a patient’s condition.
    How very satisfying that must be.
    Now, consider the doctor who cares for your situation; chronic problems with inadequate solutions. Symptoms which point one way then are countered by symptoms that point a different direction.
    How very frustrating that must be.
    Do doctors need to love their patients? Not all patients are lovable. But doctors do need to love their work. For if they love their work, their patients will directly benefit.
    Give me a doctor who listens, studies and partners with me in wringing every bit of life out of this body. That to me is love.

    Reply
    • August 29, 2011 at 10:13 am
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      Wonderful, Denise.
      And I never meant to imply loving specific patients, but as you say, loving their work of helping others.

      Reply
  • August 29, 2011 at 10:25 am
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    Do Doctors need to love their patients? That’s a great question. I honestly don’t know if LOVE is necessary… I do think that doctors need to love being a doctor. They need to love being a healer. They need to love providing good customer service to his “clients”. If you think about it, that’s all we really want. To be treated like an important client whom they wish to keep as a customer…
    My Rheumy is very professional and seems cold/distant at times. Now that I have gotten to know him, it turns out that’s just the way he is in his private life as well. He’s not excitable or overly emotional but he cares… His staff is amazing, they remember all of us on a first name basis and they make sure to greet everyone warmly. My PA is amazing. She’s the one that usually makes the connection. I had forgotten how much I connected with her, until I came in for my checkup in the middle of a Flareup. She took one look at me and she could tell I was hurting. I swear I saw tears in her eyes and instead of saying a meaningless “how are you?”, she jumped right to “What’s wrong? You’ve never looked like this before when you’ve come in…”. It almost brought me to tears and it made me love her. Few of my closest friends and family can tell when I’m in bad shape. She’s tops on that list… Sorry for rambling, but I wish everyone had as great and positive a medical team as I am blessed to have… Be well…

    Reply
    • August 29, 2011 at 12:22 pm
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      I saw one of those wonderful PA’s last week for my lower back – Yes, you’re right, it really can make you feel grateful when they are interested & listen well, like you said. I think it’s half the battle. Then after she realizes what my problem is, we can look at what the options are. I’ve been working on a post about that same thing – I didn’t think you were rambling!

      Like I mentioned to Denise above, I never thought of it in terms of “doctors love their patients” as you wrote, but was wondering about whether doctors need to love patients generally as you said “love being a doctor,” the way that leaders love humanity or nations.

      Reply
  • August 29, 2011 at 10:39 am
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    I think doctors should love what they do so much that it translates to compassion and caring for their patients. The ability to listen intently to the patient and compassionately offer either a suggestion or at least portray a caring attitude that shows he was listening.

    Reply
  • August 29, 2011 at 10:59 am
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    I think needing to “love” patients would be a bit too far. I have many relatives in medicine, and frankly, the relatives that do honestly love their patients do the worst in their own lives, suffering burnout, becoming cynical, or even becoming depressed and suicidal – and this in turn makes them tend to turn into the “bad docs” that piss us patients off. I say that as someone with a few chronic conditions of my own (migraines, moderate allergic asthma, mild eczema and moderate-to-severe environmental allergies).

    By all means, doctors should be compassionate, and they should love the work of helping people but if they get too close to individual people, they’ll suffer for it (and their future patients will suffer for it) in the long run. You can’t see people you love suffer and die on a regular basis for years on end without having it hurt you (even if there are bright moments from genuinely helping people out). Imagine how stressful your family’s worse time health-wise was for you, then imagine that stretched out, constantly, over your entire career… Anyone would get burned out and break down in that situation!

    I think medical professionals should love their work, certainly, but if they love their patients, it’ll mess with their judgement by messing with their well-being. Frankly, a doctor who’s hospitalized on a psych ward for suicidal ideation due to burnout and depression isn’t going to help anyone (happened to my aunt – admittedly, she was an RN at the time but I’m sure the same holds for doctors). To use a less extreme example, a doctor who’s so pissed off over not being able to help everyone that he snaps at everyone who so much as looks at him for too long isn’t going to be at the top of his game, either (happened to my dad for a few years – and that temper carried over home, too: he was emotionally abusive during those years).

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  • August 29, 2011 at 12:21 pm
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    I feel we need someone who hears the patient and their needs. Then takes that and goes the extra mile to see what is going on. We need a dr who doesn’t treat you like a number. But actually a person who needs their help. Warm fuzzy Dr would be nice but the reality that they are all that way is just not true. As long as they are doing their job and getting the help and information you need–that is what matters.
    -Jenni

    Reply
  • August 29, 2011 at 1:13 pm
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    I think love makes a huge difference in any relationship, including the doctor-patient relationship. Of course, love looks different here than it does between family or friends; and I’m not talking about being overly emotionally involved (as others have said, that has its dangers), but a genuine concern and care for patients is what makes a good doctor great. The smartest doctor in the world will not be a great doctor if there’s no real regard for the well-being of individual patients. My doctor is not terribly verbose or expressive, and is pretty quick with his visits, but it’s clear that he really cares about how I’m doing and that his goal is to get his patients into remission. To me, that makes a huge difference, and also builds my trust in him because I know he’s not just going off a checklist of what to do for RA patients — he’s trying to make decisions and offer options that are best for ME. That is what doctor love is all about 🙂

    Reply
  • August 29, 2011 at 1:35 pm
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    As a pastor, I’ve learned how to love those I serve and still maintain a clear sense of where I end and they begin. This is much more than loving my work. I truly love these people–which in my context of urban ministry includes a number of “unloveables”–and yet, by refusing to “merge” my self with their self I can maintain balance when someone dies or remains stuck in their pain. Of course it makes me sad and I grieve, but it doesn’t undo me.

    It would be amazing if more docs could learn to love their patients this way–and I say learn because it is a learned skill. It requires both spiritual and emotional discipline that result in being able to separate self from other without detachment. I’ve had two docs out of many over the course of my life who had learned to do this.

    But it’s a huge commitment to love this way. It requires ongoing self-examination and an opportunity to debrief with colleagues who understand this kind of love. And maybe it involves at least some sense of connection to a higher power. Since my experiences are rooted in my faith, I’m not sure what an atheist or agnostic would lean on when this act of loving becomes particularly challenging. (But I don’t presume to suggest they couldn’t love this way. Perhaps it would just be harder to do? I don’t know.)

    All I can say is that as someone who works in the midst of suffering, loving my work is not enough. Not for the long haul anyway.

    Reply
    • August 29, 2011 at 2:40 pm
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      Great comments Kris – thanks for the input. I’m wondering if “co-dependency” is something so much talked about that we’re all kind of afraid that any involvement will go there. I truly never imagined being “befriended” by my doctor or anything like that, as I wrote. But, rather, I was imagining of the kind of deep global love you describe – a passion to see people find relief and live to their potential. As I’ve been in ministry many years, we also see those in ministry who have become detached from people. They don’t ever cry about a death or whatever & it’s sad.

      Reply
  • August 29, 2011 at 2:44 pm
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    [NOTE: This comment is being edited at the request of the poster. Some personal information is being removed. Thanks.]

    Oh Kelly this post brought me to tears literally, and is right along the lines of some issues I have been dealing with medically. To be treated with love by my Dr’s is my wish. So far in my RA journey this has NOT been the case.
    I think what makes this issue especially touchy for me is that I am an abuse survivor…

    I became a ward of the state and was shuffled through the system. The foster care system was like a sea of people who I looked to for help, and who denied me help. I was not well taken care of, I was not looked after. I was certainly not loved. I was neglected. I was abused. And when I didn’t go along quietly with the abuse, when I tried to tell my caseworker what was happening, I was retaliated against by having inaccurate things being written in my record. “Troublemaker” “Defiant” “Oppositional”
    Everyplace I turned was a sea of unfriendly adult faces. The judges, the guardian ad lidems, the caseworker’s, and the foster parent’s. I never lived with my mom & little brother again. It was as if everyone I knew had disappeared. I was devastated, I felt as if I’d been ripped in half. I felt so sad and so alone. But I quickly learned that showing emotion was not tolerated. When I was missing my mom, I was punished. When I cried, I was punished or made fun of by the other kids, or beat up. When I showed any emotion, I was punished. Once I was forced me to sit on a chair facing a wall for 19 days, for lying about eating my lima beans, so I could get blueberry pie for desert…

    It didn’t matter how sick I was, I was rarely taken to a doctor. I remember those weeks of strep and being in so much pain and begging to be brought to the doctor, and being refused. It was degrading. And when I ran away at the age of 16 I swore I would never be dependent on anyone or anything but myself ever again. I never wanted to be hurt and mistreated like I was by the foster care system ever again.

    As an adult I have struggled to stay true to the promise I made myself as a young girl. I have always worked, always taken care of myself. It has definitely been a struggle! There were many times that I have gone without heat, food, or even a place to stay. But I made it through on my own & was lucky enough to marry a wonderful man who also has always done things on his own. We are two extremely independent people. I consider us to be good and honest people. We know what hard times are like and we would be the first ones to give the shirts off our back to anyone that needed help. My husband had an accident in 2002 and the doctors told him he would never work again. But he IS working and even though he could have gone on disability, he didn’t.
    I never realized up until now how blessed I had been with my health. I have always been a healthy person & never have had any serious health issues. I have NEVER been one to go to the doctor (even when I needed it). After my experiences in foster care I find it extremely difficult to go to the doctor. I never wanted to be in a position of telling the truth, and needing desperately to be heard, and being let down. One Christmas it took an emergency room visit to realize that years of pain & missed periods were because of a bursting cyst & I received diagnosis of PCOS.

    That being said (I was never one to go to the Dr.) I think this should have been the first tip off to my long time Dr. that something was really wrong when I was developing RA. But it wasn’t. I thought it very ODD that I seemed to be facing suspicion, was not believed, was told it was an emotional problem. Not only did I find it odd, it really knocked me for a loop emotionally. I really loved my Dr! I had been seeing her for a long time and I really thought she cared about me too. I trusted her so much that when she doubted my illness I began to doubt my sanity! After getting a second opinion and a diagnosis of RA she was still reluctant to believe me. It really felt like I was reliving my whole foster care experience of not being believed when I said something’s wrong. It was a nightmare.
    I still consider it odd to be faced with suspicion @ almost every turn. The doctors, I’m sure, have written inaccurate things in my chart to cover up for their misdiagnosis & failures diagnosing me correctly. This is just the way it goes in our medical system and culture now a days. As Kelly says they are motivated by fear. They don’t want to be sued. They don’t want to be held accountable. They have given me a hard time and refused to give me a referral to an endocrinologist. To be treated this way by people I once cared about & trusted with my life is just devastating on so many levels. I would NEVER sue them! But it is a culture of fear and suspicion that we live in. I think you put it really well when you said
    “All of these positive and negative actions could be motivated by love, more than by fear of legal complaints or bad publicity. Operating from a position of fear or suspicion can interfere with the ability to be a trusted helper. But operating from a position of love makes a doctor a healer.”
    Do they realize that some days I would rather be dead than have this disease and what a SLAP in the face it is to doubt me? In foster care I was severely punished for showing my emotion’s & sometimes it’s still very difficult (if not impossible) for me to open up about how I am feeling or let another person see me vulnerable. I shouldn’t have to get emotional to be believed. Would this be expected of a male patient? I shouldn’t have to look a certain way (disheveled, unkempt, thin, whatever their idea of sick looks like) to be believed.
    And honestly, I would NEVER treat anyone that way.
    In the end it this whole experience has made me realize that I wasn’t ever truly loved or cared for by our family doctor. Even though I had what seemed like a wonderful relationship with them & had been going to them for many years. Because, as you put it so well:
    “Doctors who love patients would not be biased according to negative prejudices of patients with chronic disease, assuming we’re seeking more pain drugs than we need or exaggerating symptoms to obtain disability benefits or some kind of “secondary gain.” They would not scoff at or minimize our symptoms because that is unkind. They wouldn’t write things in our charts that they know we would call inaccurate.”
    And these very actions described above are what keep me from getting or seeking treatment when I need it. I can’t stand it. It is an issue that goes to the very core of me. When I am doubted I feel like they are calling me a liar. I am NOT a liar. They are questioning my integrity, and what right do they have to do so? Because I am sick and asking for help? That is an automatic pass to treat me as “less than”?
    It may be one of the worst aspects of this disease.

    Reply
    • August 30, 2011 at 9:07 am
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      The above comment is being taken down or deleted at the request of the author. It contained important information about the relationship between doctors and patients, but some of the information was also very personal

      Reply
  • September 11, 2011 at 3:04 am
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    I don’t think they need to love but they certainly need to listen.
    My recent experience with Doctors, as someone newly diagnosed within the UK NHS system, has been awful and has left me feeling despondent and angry.
    I wasn’t a person so much as an irritation and the response to my subsequent complaint against the Rheumatologist shows yet again that they have failed to listen and apparently I’m a liar.
    This is more than frustrating when you are ill and in pain, it is cruel!
    I hoped the doctors would work with me as in the 3 months it took me to get an appointment I turned to a respected private clinic who work with rebuilding the immune system. I have huge improvement of the disease and my symptoms so wanted to complete this treatment. I was virtually threatened by the rheum that I would be crippled if I didn’t immediately take medication. As someone for whom meds have always had lousy side effects I wanted to avoid this if possible.
    With such little information forthcoming about RA during my darkest months I turned to social media and found all you lovely people. Your stories also confirmed that despite meds you still have the same symptoms and problems I’ve experienced. My GPs response when I tried to get him to listen, ‘the people who tweet and blog are likely to be the more dissatisfied ones for whom treatment isn’t working well, those people where they are doing well on meds won’t be bothered they’ll be getting in with their lives’!
    I’ll settle for the medical profession listening.

    Reply
  • September 28, 2011 at 12:17 pm
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    It has been over a year since I was diagnosed with RA. I have a plethora of other medical issues and it may have shadowed the RA because I have had these symptoms for a few years now.
    I have been treated with indifference, disdain and outright dislike by medical “Pros”. I am glad this topic came up as I have been struggling to make a choice. I now have a Rheumy that obviously dislikes me. BUT, he is brilliant and very thourough in his work. I hate to go there and feel like even less than “a number”, but is the care I receive worth the emotional rollercoaster? Maybe, is all I can think. I wish I had both a caring physician and a brilliant one. He ordered 2K worth of labs and I am still paying them off. He does not see anybody for return visit until the bill is paid in full- not just making payments. I am on SS and struggle monthly with bills. So it has been months since I have seen him. I have had several flares in that time. My GP will not change the meds he prescribed.
    I cannot seem to find the balance of medical knowledge and and emotional confidence in my Dr. Is it needed? Yes, I believe so.

    Reply
    • September 28, 2011 at 2:31 pm
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      Phyllis, my heart goes out to you! He won’t see you until you can pay the labs balance…. the whole thing is so sad. I can only tell you that you are NOT alone – and that I also hear stories of good experiences – so like you said, we’ll hope that we can find doctors who will be competant and also humane. I have a good pediatrician and some other specialists so I have faith that it can happen in rheumatology too – there is jsut such confusion over the disease symptoms themselves that I think it fosters the misinterpretations of patients’ issues and these negative experiences become more common. Hang in there!!!

      Reply

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