Back in the 1990s, I had the opportunity to read the work of Dr. Andrew Weil. His holistic approach to medicine appealed to me and I shared his books with my mom. Because I was impressed with his approach, I recently picked up a copy of his latest book, "Why Our Health Matters." In the book, Dr. Weil noted that the doctors of tomorrow will differ from today's doctors. He believes one difference will be in how doctors act and interact with their patients. "Too many patients describe their doctors as not being 'people persons,'" he wrote. "They see doctors as poor communicators who tend to be aloof and mechanical, knowledgeable about science and technology but not very comfortable around the people they serve. These deficiencies undermine quality of care."
I agree totally with Dr. Weil's sentiments, especially when it concerns doctors working with people who have Alzheimer's disease or other dementias. Based on my mom's experiences, it seemed that many doctors talked through her instead of with her. And some of Mom's doctors didn't take the time to communicate adequately with our family to explain what was going on as her dementia progressed. In fact, I think Mom's diagnosis might have happened earlier if she had built a trusting relationship with a compassionate doctor who understood Mom's fears and could communicate with her in an appropriate manner.
In his book, Dr. Weil notes that the Mayo Clinic conducted a survey of patients that asked "What traits do you want in a doctor?" The top seven traits, along with patients' comments (as quoted by Dr. Weil), were:
- Confident. "The doctor's confidence gave me confidence."
- Empathetic. "The doctor tries to understand what I am feeling and experiencing, physically and emotionally, and communicates that understanding to me."
- Humane. "The doctor is caring, compassionate, and kind."
- Personal. "The doctor is interested in me more than just as a patient, interacts with me, and remembers me as an individual."
- Forthright. "The doctor tells me what I need to know in plain language and in a forthright manner."
- Respectful. "The doctor takes my input seriously and works with me."
- Thorough. "The doctor is conscientious and persistent."
Dr. Weil also suggests two additional categories that doctors should have that are not mentioned on the Mayo Clinic list:
- Healthy. "The doctor exemplifies and models health and health-promoting behavior."
- Broadly knowledgeable. "The doctor knows all the factors that influence health and all the strategies for treating disease."
I'd also add two more qualities needed for doctors who work with those who have dementia. These traits are:
- Patience. I suggest this attribute because the doctor will need to repeat himself/herself often while explaining health issues to the patient during an appointment. I found that in Mom's case, she'd forget what we talked about in just a few moments. Therefore, the ability to repeat oneself without allowing frustration to seep in is critical for doctors working with these patients.
- Systematic. Using Merriam-Webster.com's definition - "relating to or consisting of a system; methodical in procedure and plan" - I'd suggest that doctors who work with people with dementia will need to broaden their communication strategies to include family members. In my mom's case, the doctor (who also was the nursing home physician of record) often visited her in the nursing home; these visits were not announced to family members. However, Dad and I were not present during these visits and never heard the doctor's analysis. The doctor only communicated to the nursing staff, who would give us some information if we thought to ask. However, it's not the same as hearing directly from the doctor. Therefore, it's crucial for these doctors to develop communication strategies that are inclusive, rather than exclusive of family members.
Doctors are critical players in the battle against Alzheimer's; however, how they interact with patients can will make a difference not only in the patients' well-being, but in the understanding of what's happening for both patients and their families. As the number of cases of Alzheimer's increases due to the aging of the Baby Boom generation, I believe it is going to be critically important for doctors to really embrace the traits that Dr. Weil suggests as well as the ones that I've identified. Hopefully, doctors who have these traits will become the norm sooner rather than later.