Takeaway
Caring for another clinician is complicated and requires special thoughtfulness; false assumptions about what the “clinician-patient” understands may result in suboptimal care.
Lifelong Learning in Clinical Excellence | May 16, 2024 | 2 min read
By Dr. Jeff Millstein, Penn Medicine, & Drs. Mike Fingerhood, Richard Schaefer, & Scott Wright, Johns Hopkins Medicine
“Physician, heal thyself,” is akin to the lawyer who represents themselves and has a fool for a client. Even the wisest among us will eventually need to see a colleague for preventive or episodic medical care.
Assuming the role of medical provider for a clinician may bring many emotions and concerns to the surface. Initially, we may feel proud that a colleague who intimately understands the nuances of healthcare has chosen to come to see us for sage, compassionate care over many other providers in the area. There can also be some fear or unease because this patient shares our fund of medical knowledge, skill and experience. Further, we rarely observe each other’s clinical technique after school and training, so simply having another clinician in the room may be intimidating.
Collectively, we’ve cared for many clinicians over time and have accumulated some ideas to share that may be helpful for giving exceptional care to our professional colleagues:
1. Explain that their role working in healthcare changes some of the usual clinician-patient dynamics. Clarify expectations related to decision making.
2. Ask: “Based on your work and expertise, is there anything you think I’m overlooking or should be doing / ordering to help you?”
3. Because burnout is pervasive in healthcare, check in about the stress they are experiencing in medicine and how these may be affecting their health. This may include depression, anxiety, or struggles with work-life balance. Listening empathically may help; in understanding their challenges, you may also be able to suggest specific resources.
4. Ask about coping skills and screen for substance use. Even though this is a sensitive topic, untreated substance use can have devastating consequences on their health and career.
5. Be cautious about providing curbside consultations to other clinicians about their personal health concerns. Curbside evaluation may come at the risk of missing important diagnostic clues that come from more focused objective questioning and physical examination. The clinician-patient may also be reluctant to provide more complete historical details (especially around sensitive topics) as part of this more casual due to privacy concerns.
6. Think carefully about providing a different treatment outside of the usual standard of care just because the patient is a clinician. While it is important to individualize treatment based for everyone (and to consider each patient’s occupation and circumstances), there is certainly benefit from following the patterns / guidelines that you use with all other patients.
“Physician, heal thyself” doesn’t work or make sense. Caring for our healthcare colleagues is a privilege that deserves thoughtful consideration.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.