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Modern medicine is challenging the ability of doctors to listen to, bond with patients

The culture of modern medicine is challenging the ability of doctors to develop strong relationships with their patients, potentially harming both health care and physician wellness.

Alan Glaseroff, MD, has spent most of his medical career perfecting and teaching the art of "communication as a therapeutic agent." The art has been honed by physicians for generations, but many people worry that it's suffering in the culture of modern medicine. And that's not good for patients or doctors.

Physicians interviewed for my Stanford Medicine article about the doctor-patient relationship say that health care works best when patients trust their doctors and feel respected by them. And that takes communication: listening to patients' stories, knowing about their home lives, cultures and social networks, and reflecting their values, goals, dreams and even fears in treatment plans.

Lloyd Minor, MD, dean of the Stanford School of Medicine, reminds us that at one time, physicians had few tools to heal suffering patients beyond comfort, empathy and understanding. Though an explosion of advances in biomedical knowledge and technology vastly improves therapeutic options, it also creates a "separation between the science of medicine and the humanism and compassion of medicine," Minor says.

Glaseroff, who last year joined Stanford's Clinical Excellence Research Center to help develop new models of care, is one of many clinicians who spoke for the article and are passionate about the value of strong bonds between doctors and patients, and about addressing the challenges getting in the way.  

Donna Zulman, MD, who directs the Presence 5 initiative to improve clinical encounters and overall health care, says the reasons for change are clear: Getting better patient information results in fewer medical errors; physicians whose patients trust them find doctoring more meaningful, making burnout less likely; and sick people who are full partners in their well-being are more motivated to follow through.

In a related article, patient and Stanford Health Care clinical nurse specialist Stacy Serber, PhD, says her relationship with Megan Mahoney, MD, clinical professor of medicine, was instrumental in her making long-term changes to benefit her health.

Mahoney says, "That's why I became a doctor." Her open and supportive approach, she believes, helps her patients know "they're walking this journey with somebody."

But she and others say it's tough to build relationships while balancing ever-growing demands of keeping up with the latest medical research and treatment options, and managing electronic medical records.

Glaseroff says the Stanford Coordinated Care program found success with a team approach. He and his wife, Ann Lindsay, MD, launched the program in 2011 with a goal of reducing hospitalizations for Stanford employees and family members with complex medical conditions. Patients set their own goals and the care team forms a tight network around them to coach and support them in managing their  care.

He believes that kind of approach might work in other areas of medicine, but the core principle of inviting patients into the process is paramount everywhere. That means sitting down and talking, looking people in the eye, hearing and understanding their stories, and showing them respect.

Meanwhile, Kimberly Allison, MD, a professor of pathology, says her battle against breast cancer gave her insight into the power of empathy and its benefit for patients. She shares her story with physicians, telling them that personal interactions with her care team made all the difference in her treatment.

"Medicine is not a factory," she points out in a related video. "It's art and a science."

Photo of Kimberly Allison by Max Aguilera-Hellweg

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