BATHE

When I saw patients I was able to transform from a GOOD doctor to a GREAT doctor.

I did not become a GREAT doctor because I practiced EVIDENCE BASED MEDICINE. Of course I provided better care by guiding patients based on systematically understanding what we empirically know to improve their lives and avoid hardship, but that is expected from a good doctor and patients don't know or recognize when we are evidence-based. From the patient perspective they want us to practice.PATIENT BASED MEDICINE.

And I have always been a proponent for SHARED DECISION-MAKING and including the patient in the process. Even before we had so many tools like patient decision aids through which we can provide the current evidence of benefits and harms in real time in patient-friendly formats I was publishing on participatory decision making. But that too is the way medicine should be practiced and is not necessarily experienced by the patient as something distinguishing one as a great doctor.

And of course it MATTERS that I  CARE. "People do not care how much you know until they know how much you care." But I can CARE deeply and not show it and the patient would not know. And I have seen other doctors fake it and have good patient rapport.

Patients want a doctor who cares, they want to be involved in the decision making to the extent that they personally want to be involved, and they want the decisions based on the best knowledge (evidence-based medicine). But many find their greatest needs met when all of that is done through a personal CONNECTION -- when the doctor knows them deeply and understands what it means to them. (But I have another patient scheduled in 5 minutes. Who has TIME for this?)

I learned the BATHE technique which is taught as a way to focus attention quickly on what matters to a person and empathize to show you know, to show the connection is made.

I believe this approach, making the human connection systematic in my approach to patient care in time-pressured environment, was the biggest difference-maker in me being perceived as a better doctor by my patients.

I don't see patients now. I spend my time working on ways to improve our healthcare experience with respect to evidence-based medicine, shared decision making, clinical decision support, and electronic knowledge exchange. But I see many people dealing with serious problems -- clinicians, information specialists, policymakers, etc.all struggling to make healthcare better or at least to do the best they can in a difficult situation.

Note to self: I should put the BATHE technique back into my daily habits. A deeper understanding and connection with the people caretaking for our healthcare system could go a long way.