Calling the expert

Kent Sepkowitz, MD, reflects on parallel experiences with plumbing and patients.

And yet often I dismiss their ideas with the same careless flick of the wrist I have come to expect from the latest in my long line of plumbers and dishwasher subspecialists. Like the plumber, I’ve heard that one before, whatever the complaint; I’ve previously spent time and wasted patient hope chasing the same false lead down a dead-end path. I hope I have learned from my missteps, gained in wisdom, tempered my own eagerness to order test after test. I am the one with more experience at this, right? Isn’t that the point?

Interestingly, part of the medical interview taught to first-years has a question asking the patient,What do you think is wrong?” The question is an opportunity for patients to divulge that they’ve been worried a nagging pain could be a family colon cancer, that a rash might just be from the new vegetable garden, or that there’s a cultural or spiritual reason for the ailment. In practice, this question isn’t asked as frequently as it’s taught. Is that because we stop listening as closely or because we start accumulating experience and knowledge? The balance is in realizing that there are two experts in the exam room – the doctors are experts in medicine, but patients are experts on their bodies.

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Filed under Hidden curriculum, Physician-patient relationship

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