The art of listening is a critical skill, not just in medicine but in all of life.  I expected some blow back from my last article as I inferred that finding a doc who would take the time to listen to you was both important and a difficult task.  After all, we all listen to you, don’t we?

Not really!  In my day, there was a study that showed that docs interrupted their patients’ telling of their stoies within seconds to minutes of entering the room.    Tuesday, I had two doctor appointments.  In both cases, a physician extender took my history without ever looking at me.  The assistant interfaced with the computer, not me.  My morning appointment was with the neurologist, and she not only listened to me, but reviewed her assistant’s note.

My second appointment was with the eye doc.  Again, as is the usual, a physician extender questioned me.  Unlike the first appointment, the eye doc flew through the door, did not introduce himself, examined me and left.  He did not review his assistant’s note nor expand on it[Ss1] . He did not question me.

Now I’m sure there was an occasional patient who complained that I did not listen; but, for the most part, I interviewed the patient.  It was my responsibility to obtain a thorough history and my staff’s responsibility to note why the patient was in the office, knowing that I would build on the note they left me.

It was also my responsibility to provide for the patient’s needs as best I could and, if I could not, to know who could.  Sure, there were patients who had needs I could not meet, patients who were angry, frustrated and felt wronged; but, in all but one case, I was able to defuse the situation and help the patient find specialists who might better deal with their problems.

Yesterday’s article was on chronic pain, as is this one.  The number one cause for a dissatisfied patient is chronic pain.  It is also where listening is the most important.  Sometimes, treating chronic pain involves a bit of negotiation.  There is often a gap between the patient’s needs and the treatment options.  Sometimes, the only option is to live with pain, in which case a therapist skilled in helping individuals live with their disabilities is helpful.

Recommending a pain “psychologist” often elicits anger as the patient immediately responds that the pain is real, not in his mind.  Chronic pain is always real, is always a complex mixture of physical and emotional, and needs a combined approach.  When my back flares, the pain affects all of me. 

One thing I know for sure.  Shooting up a physician’s office, murdering the doc and his staff, is not a solution! If you have chronic pain and your doc is not meeting your needs for whatever reason, find a specialist who can help you.  If, like me, you have to live with pain, look to the alternative world for possible solutions.  If you are in Illinois, you might consider medical marijuana or its derivatives.

One last point, pain not only affects you; it affects your family and friends.  They may need assistance as well. What about the drug seeker/addict?  They are sick and need care also.  They often go from office to office when, in actuality, they need a referral to a rehab facility that will address the psychological and physical needs of drug addiction.

Here is today’s joke:

I asked my wife to rate my listening skills and she said, “You’re an 8 on a scale of 10.”

I still don’t get why she wanted me to urinate on a skeleton…


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