When Doctors are Patients

How much do you know about what it's like to be a patient?

‘[it is] not what it is really like to emigrate to the kingdom of the ill and live there, but the punitive or sentimental fantasies concocted about that situation’.

@GrangerKate

Jonathon Tomlinson

abetternhs.net

@mellojonny

When Doctors are Patients

What to do

Ask patients about their experiences of illness and healthcare

Read patient narratives - articles, books, blogs, twitter.

Conclusions

Set up a peer to peer supervision and support group: meet regularly, for life.

“We are frail, we are human — bad things can happen to us, just like anybody else."

Poor standards of care

For more information, reading and support: 'abetternhs doctors as patients'

'BMJ lessons from the other side'

"I think we have to be aware of our own mortality and our own frailty as well, and not be ashamed to look for help if we need it."

“When you are faced so starkly with your own vulnerability, it does make you understand patients so much better …”

Jonathon Tomlinson

abetternhs.wordpress.com

@mellojonny

“[Doctors as patients] also became aware of how many mistakes are made, like the wrong dose of medication. They were astonished by that.”

#hellomynameis

Seeing the patient as a person

"In my first year at university I lost track

of how many outpatient appointments I sat in on – they are just another 15 min slot

in very busy day.

As a patient, my perspective couldn’t be more different … I have one appointment with my consultant a year, and spend weeks planning and preparing, then a month recovering emotionally.”

Kate Granger

“I am invariably met in A&E with comments like "you are so interesting!"

Nothing is "interesting" if you live with it day in day out …No matter what funky things my autonomic nervous may be doing, there is nothing interesting or fascinating about temporary paralysis, headaches and the day to day grind of my symptoms.”

Loneliness, shame and stigma

Loss of identity

“Then in one fail swoop all that confidence that I had gradually built up over several years was taken away when I discovered I had cancer. I felt unexplainably ashamed. I felt guilty. I felt frightened.”

“I have had unfailing family support and the best treatment available, yet I have experienced the acute sense of isolation and, occasionally, the despair endured by many cancer patients”

“Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick.

Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.”

Susan Sontag, Illness as Metaphor

“Don't assume depressed doctors know that they're sick. The view is quite different from this side of the sanity divide.

Chances are that we think that we are only stressed by work and are distressed by our perceived inability to cope.”

Lessons from 'the other side'

Chapters

1. Loss of identity

“The experience taught us how frightening and vulnerable it feels to be on the other side”

2. Loneliness, shame and stigma

3. Seeing a patient as a person

"Some joked that ideally, medical students should be hospitalized and forced to sleep in patient rooms to experience the disruptions, inconveniences and humiliations that patients routinely encounter."

4. Poor standards of care