October 13, 2011

The Provider will Teach Your Now


In the last day or so I have seen a a few pieces on the role of phyicians, and patients or providers and consumers. On was a New England Journal of Medicine piece (who would think that I read that rag? - certainly not me) by Hartzband and Groopman titled, "The New Language of Medicine" (1).

It was a good article. I like this part particularly:
"The word “patient” comes from patiens, meaning suffering or bearing an affliction. Doctor is derived from docere, meaning to teach, and nurse from nutrire, to nurture. These terms have been used for more than three centuries."
So to me this suggest that maybe when doctors move away from teaching to a detached paternalistic approach, that projects a perception that they are 'the expert telling the patient what to do' they may have changed the historic relationship. In all fairness, this may be a function of the pressure to see patients and quickly, diagnose and treat before moving on the the next bearer of ill news. I notice there isn't any teaching the sufferer in that little process.

Teaching, it seems to me implies there is a need to for the bearer of an affliction to understand what is going on. Even more it seems to appreciate there is some autonomy in the patient's selection of what to do after said bearer has learned from the teacher.
 
From my experiences as the father of type 1 diabetic teens, the biggest contributor to managing their wellness are great teachers. Some have physicians. Some CDEs. Many have been others who are carrying the same load of daily diabetes care. We have found many of that later group at Children With Diabetes Friends for Life. I am looking at folks like Joe, Paul, Jim and Natalie.

So while Hartzband and Groopman worry about language that demeans the professions of doctors and nurses it seems to me that those professions should also pay attention to the role to teach and nurture and the fact that others outside of the professional ranks help in that process.

(1) N Engl J Med 2011; 365:1372-1373October 13, 2011