Don’t Keep The Patients Naked — Give Them Back Their Clothes
Don’t Keep The Patients Naked — Give Them Back Their Clothes
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The military service ribbon above lets you know that the soldier wearing it served in Vietnam. Indeed, you can know a soldier’s career just by “reading” the ribbons on his/her left upper chest. That ribbon also tells you a lot about that person. Vietnam was fought before the draft was ended in 1973.(1) So, it’s likely the patient was drafted, usually right after high school, because he (women weren’t drafted) did not get a college draft deferment or a deferment followed by an advanced degree deferment, like for going to medical school. It’s also likely he did not grow up wealthy because financially fortunate families were more facile at obtaining deferments.(1) The author David Halberstam has said, “Vietnam was a place where the elite went as reporters, not as soldiers. Almost as many people from Harvard won Pulitzer Prizes (an award for journalism) in Vietnam as died there.”(1). What’s my point? Clothes tell a lot about an individual. But who cares?
Medicine is so rushed these days, with completing the electronic medical record and getting all the charting done and finishing the panel of patients before the staff must leave. Clinicians often cannot take the time to learn personal things about the patient. Modern medicine literally strips patients of their clothes and figuratively strips them of their identity. So, it’s important to give patients back their identity. Key things like what they do for work, how many children or grandchildren they have, or what they are most proud of are useful in giving patients their identity. I frequently write such items in my office note and use them to remember both the patient and what’s special about them. This is not to provide different care based on someone’s background or social status. It’s to know them as people as well as patients. And I bet it improves medical care. Patients are more likely to take prescribed medications and less likely to initiate malpractice complaints if they think you have a genuine interest in them. I call this process of knowing something about them personally as “giving them back their clothes”, but it’s really about giving them back their identity.
This piece is from my “500 Rules of Cardiology”, not really rules, not really 500, and quite presumptuous on my part, but they are simple sayings and principles I have used clinically and in teaching. Please share them with trainees and colleagues.
