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The Devil’s Advocate: All doctors should be patients

The third in our series of blogs challenging the status quo, come take a trip down to meet with The Devil's Advocate as he argues the case that doctors should have experience of being patients.

In the deepest circle of #MedEd hell, lives the devil’s advocate. Thinking the unthinkable. Voicing your deepest and darkest thoughts about the world of medical education. Why not join us, in this series of entries challenging the status quo, to take a trip down to meet the Devil’s advocate?

The devil’s advocate was recently unwell and was admitted to hospital. During my stay on an orthogeriatric ward (thank you, winter pressures) a number of things struck me: how much waiting around there was, how little I knew of what was happening, and how much I love Oramorph. Poor attempts at humour aside, I spent much of my time waiting for people to see me, with little idea what was going to happen or what the plan was. Even with the knowledge that so much of medicine is uncertain, and that time is an excellent diagnostic aid, I was left feeling very powerless. It struck me that if I felt this way, as a person with a fair few years of medical experience, who was more than happy to ask questions and expected answers, how would a “lay person” feel - let alone someone who was elderly and vulnerable.

All in all, despite the above revelations, the care I received at my local hospital was exceptional and I am deeply grateful for what they did. And now, discharged from hospital one appendix lighter and one unforgettable PR later, I have had some time to reflect – using the infamous three stage model no less – and one clear thought comes to mind.

All doctors should have experience at being patients.

Junior doctors are, largely, a relatively healthy bunch. Yes, our stress and caffeine levels run at dangerously high levels most of the time, but overall the levels of illness are relatively low. While there may be a variety of confounding factors – under reporting, self-medicating, a certain level of youthful vitality – the majority have limited experience on being on the receiving end of healthcare. This is particularly true of our male counterparts, who without contraceptive or obstetric appointments can go years at a time between visits to the GP.

For those who rarely are in need of the services of the NHS, it is easy to see how they may become detached from what it is actually like to be a patient. This is confounded by the fact that illness, pain and a whole host of symptoms become normalised by constant exposure.

There are of course a plethora of exceptions. There are many doctors with chronic conditions or disabilities that result in frequent exposure to healthcare from the other side of the table. And I would argue that they are better doctors for it. It seems well established in medical education that we can teach all the theory that we like, but there is no substitute for experience. Surely therefore, having experience of being a patient makes you more understanding, empathic and overall better at your job?

This is hardly a revelation. There are countless blogs, far superior to this, by those doctors who live with a variety of health conditions, all highlighting good and bad practice with valuable lessons to be taken from them: Dr Kate Granger’s #hellomynameis campaign perhaps being the epitome of this. To me the most striking message in all of this is, that while as a profession we continue to get better and better at treating conditions, looking after patients can fall by the wayside. And whilst all the blogs, campaigns and mandatory e-learning packages can go some way to addressing this issue, nothing will drive home these messages like personal experience.

So, the devil’s advocate’s case is that all doctors should have experience of being a patient in the service they provide. Surely it will improve the empathy, communication and care offered and may well pave the way for all sorts of quality improvement projects looking at previously hidden issues.


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