What I Would Have Done Differently in Practicing Medicine

By: Deborah Winiger, MD

As I have matured in my medical career, my medical knowledge has obviously improved, although I am still challenged often with difficult cases and unfamiliar diagnoses.  I think the biggest change I have seen is in my general evaluation and assessment of patients is being able to read emotions and find the ulterior motives and goals of patients when I meet with them. 

Understanding patient motivations helps me make a diagnosis and treat conditions.   One of the most important things I think I have learned in treating patients is you can’t want them to get better more than they do.  I still get frustrated when patients don’t want to follow instructions, have more excuses about why they can’t stick with a diet or find time to exercise, and refuse preventative tests or screening.  But now I am able to learn to work with what patients are willing to do - I still give my best advice and tell the patient I am doing a disservice if I don’t but try to find small steps to make progress in their health.

The other part of patient care that can be challenging is you can’t please everyone.  I pride myself on developing relationships with patients and spending time getting to know them and their families.  I used to be offended when I thought I had developed good rapport with a patient and provided excellent care, only to find out they complained about everything from our check-in process to having multiple open appointments but not the exact fifteen minutes they are available.  I once had come in to see a child on Christmas Eve for an ear infection but when I asked his parents to schedule a follow up to recheck his ears to make sure his infection cleared, they didn’t want to pay for the visit.  Patients often want to do visits by phone or email but when asked to pay even a nominal fee they refuse. 

I have learned now to not take things personally and know that although they may seem to be attacking me and my practice personally, there is often a different motive in not wanting to be honest or financial issues.  If I had known this early in my practice it would have saved me a lot of hurt feelings.

The great thing is how much I learn from my patients and enjoy engaging in their lives to help improve both their mental and physical health.  It makes it worth coming to work every day.