Caring Versus Care

Many athletes start second careers as broadcasters. Viewers love to hear from someone who spent time doing what others can only talk about.

Every profession has pundits and players: people who do and others who just talk. Even those who actually do what they love to talk about, sometimes confuse talking with doing.

Care versus Caring

Most doctors notice when they spend time away from clinical care. They feel out of touch. Physician leaders often insist on a few hours each week to spend with patients, to remember why healthcare exists.

If doctors feel ungrounded after only a few days away from patients, imagine how bureaucrats and politicians must feel? They work in an industry in which they have never practiced themselves.

Even if they have been sick, and are experts on experiencing care, they will never know medicine from the other end of the stethoscope.

Only a few doctors write or talk about caring. Maybe it is too hard: How do you capture any existential event with words?

Loss for Words

Every patient wants to be cared for, but they often only get care.

Is caring only something that is given, or must it be received, too?

Caring for patients seems to require an exchange. Doctors give a bit of themselves and get something back in trade.

This makes physician burnout devastating for patient care. Burnout causes exhaustion, cynicism and doubt. Doctors feel drained and become emotionally unavailable. They question whether work makes any difference.

Burned out doctors cannot care. They provide a technical service: diagnosis and treatment. Burnout prevents doctors from acting as partners in a therapeutic exchange.

Not that doctors care only to get something, but rather, caring for patients is, ipso facto, a human exchange.

This halting attempt leaves too much unsaid. Perhaps wisdom advises silence when we cannot describe a thing in the fullness it deserves.

Pro-Patient

I said something stupid in my interview for Medical Director, my first admin job. I had no idea what administrators thought about doctors. I also did not realise that most administrators are nurses.

The search committee, all administrators, opened with, “Tell us something about yourself.”

I said, “I am pro-physician.”

Everyone froze. Pens hovered. Mouths gaped.

I dug in deeper.

“I am pro-physician,” I said again. “I am pro-physician, because I am passionate about patient care.”

My panelists stared back, Are you serious? They had never seen a doctor talk like such a fool. I worried they might laugh out loud.

“Burned out doctors cannot provide great care,” I said. “Only enthusiastic, inspired doctors can give the compassion and care that patients need. Burned-out, beaten-down doctors will never give the care that patients deserve.

If we want patients to get the best possible care in our department, then we need to make sure that doctors have their needs met. Doctors can’t be worrying about supplies, or parking, or funding cuts, if we want them to focus on patients.

I’m here to make sure doctors focus on patients, first, and never need to worry about anything else. That’s why I’m pro-physician.

I am pro-physician, because I’m pro-patient care.”

Mouths snapped shut. They all dropped their heads and scribbled long notes in silence. I got offered the job, interim of course.

Why Healthcare?

Pundits and wonks, like me, worry too much about medical politics.  We need doctors, who care less about healthcare and more about caring, to speak and write about medicine.

As wait lists grow and people fight over funding, the business of medicine distracts us. But healthcare means nothing without patients. An industry that provides care means nothing, if it forgets what happens at the bedside.

We need leaders who talk and do. We need doctor broadcasters. We need expertise in care and caring, and we need leaders who know the difference. We must never lose sight of the only reason healthcare exists: caring for patients.

Photo Credit: cbc.ca

PS – Thank you, Dr. CF!