醫生請閉嘴、仔細聽

The Opinion Pages | OP-ED CONTRIBUTOR

Doctor, Shut Up and Listen

By NIRMAL JOSHIJAN. 4, 2015

Photo

CreditJeannie Phan

Doctor, Shut Up and Listen
http://nyti.ms/14bgED2

這個標題吸引了我，什麼事要讓醫師閉嘴呢？

故事提到一位因為心悸看了6個醫師的女性，後來被轉給精神科。精神科醫師仔細的評估，發現患者在服用減肥藥，請她停用後，症狀就解決了 ，問患者為什麼沒有向之前醫師說有在服用減肥藥呢？患者說"she’d “never been asked."

文中提到，根據一個研究，大約一半的出院或是門診患者，對於醫師的診斷或是病情指示，仍然不清楚。醫師平均只聽患者18秒，就打斷患者的談話。

另外，缺乏同理心，也是一項問題，例如，有次患者淚流滿面談到自己親人的過世，醫師下一句話就問 “How is your abdominal pain?”

另外，「A good bedside manner is simply good medicine.」
醫師也是需要表現地有禮貌，具良好的溝通技巧的，例如作者的同事有一次就說了一個例子：一位控制很差的DM患者，遇到一位熱心的女meta醫師，

“I can’t continue to do this anymore,” he told her, on the verge of tears. “I’ve just given up.”

She placed a hand on his shoulder and just sat with him. After a pause, she said: “You have a heart that still beats, and legs you can still walk on — many of my patients don’t have that privilege.”

Five years later, recalling this episode, her patient credits her with inspiring him to take better care of himself. The entire encounter took less than five minutes.

患者還是非常需要醫師鼓勵的

舉我診所的例子，一位吐coffee ground的洗腎患者，請他去胃腸檢查，家屬猶豫，不是很急切，我心想真是奇怪。後來，問起原因，才知道不良於行的患者，出門還要兒子沒有上班時才能載送，家屬又不想影響兒子的工作，不想讓兒子請假，真是天下父母心啊！

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Nirmal Joshi is the chief medical officer for Pinnacle Health System.