Double Edged Sword


In a recent KevinMD blog the term “doctor’s emotional switch,” was used by Dr. Mark Abrams to describe the protective coping mechanism ingrained in medical training to objectify their patients and thereby maintain emotional distance. He notes that this approach can have both positive and negative effects. 

No doubt that we’d like our doctors to be current on the science of medicine, make the correct diagnosis and offer an effective treatment. Yet, I imagine we’d also like to be seen and cared for as a person facing a serious illness, which can be life altering.

Dr. Abrams recognizes the dilemma that doctors’ face with less time for office visits and increased documentation, which can translate into restrictive conditions for conversations. Now, we find doctors typing into an electronic medical record. The nature of visits these days can leave us little opportunity for the “doctor’s emotional switch” to be turned off.

Oftentimes, patients have said, “My doctor’s visit was so impersonal!” Frankly, it’s not a matter at pointing fingers at doctors. Patients also share a responsibility to ask questions and express concerns beyond just responding to a checklist.

A recent conversation with a primary care doctor offered a good example of how to help humanize the doctor-patient interaction.

The doctor told me, “I’ve found inviting patients to sit beside me at my computer to be less threatening. Invariably, I’d warn them my computer skills were less than perfect, which never failed to elicit a smile. The invitation to see what I’m doing helps to get us on the same page in working on a care plan.”

This doctor demonstrated there can be creative ways to place the “doctor’s emotional switch” on hold. The first step is for both doctors and patients to talk about what may be barriers to open and honest communication. And, taking time to recognize the importance of the human connection can help build a healthcare partnership and will likely have a healing effect on both doctors and patients even with a computer in the room.

One Comment

  1. Wow, it’s hard for me to imagine a doctor inviting me to sit beside him or her at the computer. Interesting. The best doctors I know, like Jonathan LaPook, either (somehow & simultaneously) listen AND touch-type AND maintain eye contact, or (like my ob gyn) just stand near me and talk, consult ample paper notes, and listen. But an intriguing and courageous suggestion. Some thoughts from my own field, college teaching: I read years ago in a book on teaching that faculty offices are typically on the upper floors of a campus building, leaving the lowly students at ground level while the profs often hide up there behind their closed doors. And I’ve seen so many colleagues sit behind their desks, eyes on a page, while the massed students just sit there dumbly facing therm. It’s hard to engage, but one must try. And of course patients have to make the effort to ask the doctor questions.

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