Doctors Guided by the F-Word

We expect to get a dose of the facts when we visit the doctor: details of our health, maybe a diagnosis, then a prognosis for the near future, with a swift good-bye. Yet what if these facts were heavily influenced by something less objective?

This happens every time we interact with a medical professional, or with anyone. Because whether we realize it or not, each one of us is guided by that dreaded f-word, our feelings.

In fact, Danielle Ofri, associate professor at NYU School of Medicine, recently shed light on how doctors’ natural feelings continue to influence their work.

We flipped when we first read it! Check out what Dr. Ofri says:

By now, even the most hard-core, old-school doctors recognize that emotions are present in medicine at every level, but the consideration of them rarely makes it into medical school curriculums, let alone professional charters. Typically, feelings are lumped into the catch-all of stress or fatigue, with the unspoken assumption that with enough gumption these irritants can be corralled.

Boo, hiss! Looking at emotions as “irritants [that] can be corralled” is very 2011. So out with the old wisdom; Ofri goes on with the new:

The emotional layers in medicine, however, are far more pervasive. Emotions have been described by the neuroscientist Antonio Damasio as the “continuous musical line of our minds, the unstoppable humming …” This basso continuo thrums along, modulating doctors’ actions and perceptions, while we make a steady stream of conscious medical decisions that have direct consequences for our patients. Emotions can overshadow clinical algorithms, quality control measures, even medical experience. We may never fully master them, but we must at least be conscious of them and of how they can sometimes dominate the symphony of our actions.

Ofri then describes how she helps her team work with their feelings, not against them:

Today, at least, when my medical team faces the prospect of giving bad news or admitting a medical error, I try to help my students and interns pay attention to the basso continuo running underneath. I try to point out when our emotions might be impeding us, and when, as sometimes happens, they might be assisting us in caring for our patients. Doctors can’t — and shouldn’t — eradicate the emotions that grease the wheels of patient care. But being alert to them can help us minimize where we fall short, and maximize where we succeed.

One more time, consciously using our emotions on the job can maximize our success.

We’ll take that as the doctor’s orders.

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