The Argentinian way

There’s a medical saying in Spanish that I wish translated better, but goes something like: “The doctor who only knows medicine, does not even know medicine.” I can’t recall the number of times I heard this phrase throughout medical school back in Argentina. It’s a great reminder that even though medical knowledge is extremely important to patient care, it’s equally important to understand that the disease is related to other aspects of the patient’s life.  

Argentina is known worldwide for its welcoming culture, and we take great pride in the immense value we put on interpersonal relationships. This goes far beyond friendship and family. For example, lunchtime is always a gathering and opportunity to share and interact—even at work. Lunch is an implicit “protected time” for relationship-building.  

We’re known internationally for team sports and music, dancing Tango, having a dedicated weekend day for a feast among family/friends that we call “asado,” and even having a national Friendship Day on July 20. We greet each other by kissing the other’s cheeks, there’s a very low threshold to hug, pat on the back, or hold hands. We even share the same straw while drinking our national drink, mate.  

Why do strong interpersonal relations matter in Argentinean medicine? First, many diagnostic tests and procedures are delayed because of a higher demand in relation to supply. And most results and clinical interpretations take longer than in the U.S. Moreover, some treatment options are just not available in Argentina. This setting makes interpersonal skills even more crucial to sustain an honest, long-lasting, and trustworthy patient-physician relationship, where communication and empathy are key players. This also enables the physician to take the position of a healer and companion through illness instead of just a diagnostician. 

Fundamentally, knowledge regarding signs, symptoms, clinical presentations, differential diagnosis, work-up and management is important. Yet, it is the patient-physician relationship, bedside manners, empathy and emotions that patients remember from our encounters. 

Here are a few things I carried with me to the U.S. from medical training in Argentina:  

1. Get to know a patient beyond their illness. Ask about their hobbies and what they look forward to after hospital discharge. 

2. Seek to understand the role of a particular disease in the context of the patient’s life. 

3. Acknowledge any other non-medical cause of patient’s distress. 

4. Even topics such as hobbies, sports, food and climate could constitute the initial step in building a relationship. 

5. Establish and maintain visual contact when conversing.

6. Follow-up on a prior topic of conversation in your subsequent encounter, like a movie they were watching, a family member they mentioned, a book they were reading, or anything non-medical related. 

It’s the patient-physician relationship, bedside manners, empathy, and emotions that patients remember from our encounters.

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.