What doctors really need to do is become better actors - then patients might even think they know what they're doing
Phil Hammond MD
Tuesday 10 December 1996
Great suggestion. Two months and no applicants later, we were forced to conclude that all doctors must already have excellent caring skills. What other explanation could there be? I've since moved on to another head of department, so it's time to dust off those old ideas and present them as new. Only this time I've got the Lancet behind me. "All doctors need to be better actors," say Canadian researchers in a recent issue. "Only then can we respond to our patients' emotional pain."
There are many obvious comparisons between doctoring and acting: mumbling, hiding behind the props, upstaging the central character, being in the wrong play, forgetting your lines, ad-libbing with inappropriate humour and, worst of all, getting the entrance wrong. Yep, despite nature's helpful colour-coding, there are still a few doctors who try to visualise the cervix through the back bottom, or check for piles in the front one. Some call it gross professional incompetence, but I prefer bad acting.
Even the General Medical Council has jumped on the acting bandwagon with its proposal to check up on incompetent doctors using fake patients. Aside from providing a glimmer of employment for drama graduates, it sets up the tantalising prospect of bogus patient meets bogus doctor. "Good morning. And what seems to be the problem?" "I've no idea." "Neither have I." "I'll say goodbye then." "Goodbye." It'd be funny if it didn't bear such a close resemblance to my own consultations.
I like to think I'm reasonably honest with my patients - I give them as much factual information as they seem to want and I try to get them to realise that medical science doesn't have all (or many) of the answers. A few brave doctors do extend the concept of honesty to include sharing all of their emotions and attitudes with their patients. Usually it's the old self-disclosure-plus-reflection routine. "You're making me feel quite frustrated Mrs Robinson. How does that make you feel?" But occasionally you get a GP who'll go the whole hog. I know a senior partner who summons patients over the intercom with "C'mon Mrs Morris, you great jelly belly. Get your big flabby arse in here." I'm reliably informed that this brightens up the waiting room no end and that even the victims love him all the more for his earthiness.
Clearly, professional decorum dictates that emotional honesty can go too far and there are times when it's wise to disguise your true feelings, eg "I've always admired your upper body" is not the thing to say when you're listening for a heart murmur. So that's when acting comes in. On my courses, doctors are taught to disguise inappropriate attitudes and emotions and "enhance-out" later. One practice I worked in has a "heart- sink" patient football team comprising the 11 most difficult patients (plus two on the bench). After a murderous consultation, the doctor will run out to the coffee room and replace yesterday's heart-sink with today's. It's a marvellous way to de-stress doctors without harming the unwitting clientele of Sunbanks Surgery, 124 Maryvale Rd, West Thursley.
Of course, there's far more to acting than disguising emotions. You have to learn to take on a variety of roles. Some patients want you up on a pedestal, others like an equal partnership and an increasing minority want to dominate you. Alas doctors, like lovers, learn a particular pattern of behaviour early on in their careers and stick to the same role for life. Patients visiting a group practice soon suss this out: Dr Clements is the practice bastard; you won't get much sympathy but you'll be in and out with your antibiotics in 30 seconds. Dr Hughes you have to book three months in advance but she's very good with emotional disasters. How much easier it would be if every doctor offered several roles for you to choose from. So for this term's course, I'll be teaching doctors to consult in the roles of a fit Mother Teresa, a fit Ruud Gullit, a bad Olivier and a burnt-out, divorced, alcoholic bigot. If you feel I've missed anyone out, please let me know before the timetable goes to print on Friday 13thn
Life & Style blogs
Versace haute couture review: Beautiful evening dresses are some of the loveliest Donatella has ever created
The face of fertility: why do men find women who are near ovulation more attractive?
What supermodels really think about posing in the nude
People all over the world are getting semicolon tattoos to draw attention to mental health
What do the emojis on Snapchat mean?
More Britons believe that multiculturalism makes the country worse - not better, says poll
Nathan Collier: Montana man inspired by same-sex marriage ruling requests right to wed two wives
Osborne to cap family benefits at £23,000 – announced ahead of his post-election Budget
Greece crisis: IMF was pushed around by Angela Merkel and Nicholas Sarkozy – and now it is being humiliated
Forget little green men – aliens will look like humans, says Cambridge University evolution expert
Girl, 7, stares down hate preacher at Ohio festival with pro-LGBT rainbow flag gesture
- 1 Humans of New York image of crying gay teen receives best response from Ellen DeGeneres
- 2 What supermodels really think about posing in the nude
- 3 People all over the world are getting semicolon tattoos to draw attention to mental health
- 4 Swedish minister gives strongest case yet on why EU should stop turning away asylum seekers
- 5 Chris Moyles reportedly set to make radio comeback with new breakfast show on XFM
£30000 - £35000 per annum: Recruitment Genius: This company provides a number ...
Negotiable: Recruitment Genius: A Facilities Coordinator is required to join a...
£35000 - £45000 per annum: Recruitment Genius: A dynamic, customer oriented Pr...
£18000 - £20000 per annum: Recruitment Genius: This is an inbound relationship...