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...seems like you're trying to get people to think of doctors in a less clinical, more human way, and to recognize that there are emotions on both sides contributing to the successes and failures. Absolutely. I think one of the great things about House is that often in solving the problem, it's something in his real life that triggers a thought about his patient. I think fundamentally what doctors and patients both have to remember is that the diagnosis process is a collaboration between two experts: the doctor, who is an expert on the body and disease...
...talk a lot about the death of the physical exam too. You attribute that, in part, to another very human response: doctors feeling awkward about touching another person in an intimate way. That's not something we hear about very often. I don't know that this has ever been studied in a systematic way, but it is, I think, very natural to feel uncomfortable touching people that you barely know. There are a lot of rules in our society about touching - who gets to touch, and where, and how. Even when you're in the crowd that's allowed...
...patients help themselves get the best diagnosis? The most important thing that the patient can do is tell their story. Doctors often interrupt patients. There have been several studies done that show that on average, doctors let patients talk for 20 seconds before interrupting. Some doctors interrupted after only three seconds. Once interrupted, patients are often reluctant to go back to their story. After you answer the doctor's question, say, "Let me just go back and tell you what happened." I also think patients need to be empowered to ask doctors to explain things in language they can understand...
...often do you provide end-of-life counseling? It comes up very frequently in our practice, either with new patients who present very ill, or patients we have known for a very long time that have encountered a new serious condition that may be life-threatening. Death is not an option. Everyone is going to die at some point...
...often does money come up with families or patients when you are talking about end-of-life care? This is a question that medical students often ask. Health-care finance and social issues regarding health-care expenditures nationally are policy issues, and they are never to be decided at the bedside...