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For Patients, What Makes a Great Doctor?

Anna is an elderly, vibrant patient who doesn’t remember what brought her to the hospital this time, but she enjoys company, and an audience for her life’s stories. She tells me about growing up in the only Hispanic family in an Italian neighborhood, raising her children, becoming a widow, adopting a few too many stray animals over the years and becoming a widow for a second time. She tells me about her past illnesses and the doctors who have taken care of her.

This visit was facilitated by Project Kindness, a voluntary program and partnership between Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center’s Jack D. Weiler Hospital. Through the program, which began in full this year, medical students (including many first- and second-year students) spend personal time with patients, listening to their stories and validating their experiences.

Woman holding the hand of a patient in a roomUltimately, the hope is that these visits can improve the experience of the patients and their families, while also providing medical students with a reminder of the human aspect of medicine and offering them a chance to practice the art of the physician-patient relationship before their third year.

Preserving Empathy
It’s no secret that the demands of medical training and practice take a toll on physicians. It has been found that empathy declines throughout medical training, and practicing physicians miss nearly 90 percent of the opportunities that arise for expressing empathy, even though empathic interaction adds no time to a visit.

Unfortunately, patient satisfaction, autonomy and even physical health have been found to suffer when doctor/patient interactions are lacking in empathy. Programs such as Project Kindness seek to help stem this decline during medical training.

Person to Person
At the beginning of my Project Kindness visits, I begin by explaining to patients that I am there to provide some company and to hear their stories. Normally, as I sit down by their bedsides, we begin with small talk: “Are you from the area?” “Any hobbies?” Sometimes, the conversations stay light; I spent most of a visit with one patient comparing the various baseball stadiums we had visited. (We agreed that PNC Park in Pittsburgh was the prettiest, but Fenway Park in Boston topped the list because of its history and rowdy fans.)

Other visits have a more somber tone. A patient in intense pain and struggling with each breath was anxiously awaiting the results of her most recent tests. She hoped they could provide clarity to her medical team, who had been trying to identify the cause of her symptoms for more than a week. Her eyes filled with tears as she explained that she would be missing her youngest son’s sixteenth birthday party the next day and wondering if she would be home for the holidays.

Patients as Teachers
It is a unique experience to join a complete stranger at a time of uncertainty and vulnerability. I often wonder, if I were on the other side of this relationship, whether I would be so willing to open up. But as I sit by their bedsides, I can often see patients’ features lighten, and sometimes their pain appears to subside as they begin to share their experiences with me. Empathic listening is powerful medicine.

Most of the patients I have visited through Project Kindness are seniors with chronic illnesses that have required multiple hospitalizations over many years. They are, therefore, in a unique position to comment on what a great doctor looks like. So before concluding my visits, I ask the patients what advice they might have for me as a future physician. Although their stories and symptoms differ, their advice has been both consistent and invaluable: Stay humble. Be kind. Take the time to listen.

Editors’ Note: Project Kindness is supported by a generous grant from Gemiluth Chessed of Greater New York.

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Patience Gallagher

Patience Gallagher

Patience Gallagher is a second-year medical student at Albert Einstein College of Medicine. Prior to coming to Einstein she spent four years doing genetic research in the Psychiatric and Neurodevelopmental Genetics Unit at Massachusetts General Hospital. At Einstein, she continues to be involved in genetic research, is the president of the Einstein chapter of the American Medical Women’s Association, a member of the WellMed committee, and a participant of Project Kindness since its inception in the spring of 2014.

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