I spend much of my day listening to people’s experiences with their health. I hear how overwhelming it can be trying to absorb information after a diabetes diagnosis and figuring out the next steps on the path to diabetes management. I hear how challenging it can be to juggle diabetes management with family and professional responsibilities. And I am deeply moved by the power of these stories.
I can only imagine what it must be like for healthcare professionals who hear many more similar stories every day, and how that impacts their relationships with their patients. When I read a post by Dr. Danielle Ofri, M.D., Ph.D., on doctor priorities vs. patient priorities in The New York Times®, I knew I wanted to hear her perspective.
The Doctor-Patient Connection
Shortly after her residency at Bellevue Hospital at New York University (NYU), Dr. Ofri began writing down some of the stories of her experiences as a new doctor. “Seeing the many layers of a patient experience was eye-opening, and writing gave me a chance to remember that there are other perspectives in life,” she said. After taking a creative writing class on a whim, Dr. Ofri collected the stories into her first book, “Singular Intimacies: Becoming a Doctor at Bellevue.”
As she has worked with her patients through the years, this idea of different perspectives has stuck with Dr. Ofri. “I realized that listening to the patient’s story has powerful therapeutic implications,” she said. “Every patient has a story to tell, and to really understand their illness you have to hear the stories. Someone’s story of how they live with their illness is unique and fascinating and ever-changing. To me, that’s the beauty and intrigue of medicine.”
To get to know her patients better, Dr. Ofri often adds questions about their social history to their intake questionnaires, asking immigrants where they’re from and why they moved, as well as the extent of their education. “Some patients have had very little schooling, and if I give them 16 medications with different schedules and they can’t read, they won’t be able to take them,” she said. “I try to keep track of what’s happening in their lives and their families because I think this is as critical to their health as their A1C or their LDL.”
Now as an Associate Professor at NYU School of Medicine, Dr. Ofri encourages her medical students to include patients’ personal stories in their medical histories paperwork. She also co-founded the Bellevue Literary Review in 2001, which publishes fiction, nonfiction and poetry related to the human body, illness, health and healing.
The Human Experience
Dr. Ofri shared the story of one patient who lives with type 2 diabetes. For several years, her patient’s A1C level has not been in the single digits. In talking with her, Dr. Ofri learned she is a single mother with a teenage daughter, and struggles to make healthy eating choices while living on food stamps.
“It was just all very human,” Dr. Ofri said. “It wasn’t that she had disregard for her health or care, but life was difficult for her. I tried not to harangue her about her diabetes. We maintained the connection and just hung in there.” It took several years of working together, but eventually they found some solutions that helped the patient achieve slightly better blood sugar control. She continues to work toward her A1C goal, and Dr. Ofri considers the fact that she continues coming to her medical visits a success.
Such cases may present a challenge, says Dr. Ofri. “It’s frustrating and very time-consuming, but chronic illness is a marathon, not a sprint. You can yell at a patient all you want about taking their medications, but if I want any success as a doctor, you have to go with their priorities. In addition to having a medical condition treated, patients need to feel like someone’s taking care of them. It’s not ‘healthcare delivery;’ it’s care.”
What Doctors Feel
For Dr. Ofri, the doctor-patient relationship is very important. “I think we have to recognize that emotions do come up,” she said. “This patient is a good example. She has many stressful situations—with her daughter, with her job, with her finances—that have upended her life. I have to be prepared as a physician for her emotions, and also mine. If I were to ignore her feelings—or mine—we would have a much less fruitful relationship. Ultimately her healthcare would probably be poorer for that.”
Learning more about her patients is rewarding on multiple levels for Dr. Ofri. “Almost every patient wants their doctor to know about their life because they want to be something more than just their illness to their doctor,” she said. “I’ve found that we can make much more headway medically when I have a better understanding of their lives.” Dr. Ofri shared some of these insights in her recent book, “What Doctors Feel: How Emotions Affect the Practice of Medicine.”
As we talked, it was so apparent to me how much Dr. Ofri cares about people. I applaud her efforts to not only treat, but care about her patients. Many thanks to Dr. Ofri for sharing her experiences and insight.
All the best,
Disclosure: Dr. Danielle Ofri received no compensation for this post. All opinions contained in this post reflect those of the interviewee, and not of Sanofi US, its employees, agencies or affiliates.
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