In a recent tutorial, I
shared my reaction to a client-physician conversation from the short story Something’s Wrong—Please Listen to Me! in Privileged Presence: Personal Stories of Connections in Health by Liz Crocker and Bev Johnson with my fellow OT group. In the
story, the client had been seeing her doctor for a while and when the doctor
wanted to reduce her medication very quickly, the client spoke up to say that
she felt that it was too quick for her. The doctor’s response had been, “But if
you want to get better, you have to follow my instructions.” And after a while,
this doctor told the client that “We’ve outgrown our relationship.”
My immediate reaction
after reading that last phrase was shock, anger and a feeling of having been offended by
this doctor. I felt offended that this doctor could be in the “helping
profession” and give up on the client without trying to talk it out with the client
to assess their needs or try out alternative ways to reduce her reliance on the
medication. I shared how I felt that the doctor did not communicate in a way
that was professionally responsible with my OT peers and we discussed how this
was reflective of the importance of open communication that was brought up in
a recent lecture on therapeutic relationships.
The very next day, I
was meeting a friend who is currently in 2nd year medicine over a drink (Starbucks Buy One Share One event!) and I decided to share
my reflection with him. From my point of view, the doctor in the story was not
being very client-centered and came off as very rude. After hearing my rather
negative appraisal of the doctor, my friend looked a bit concerned. Being calm
and collected in nature, his response consisted mostly of a series of questions
for me:
- Do
you know both sides of the story?
- How
long has the doctor been seeing this patient?
- What
else has this doctor done for this patient?
- Do
you know the patient’s history with other health professionals?
- Do
you know exactly what happened in terms of the entire conversation?
- This
is a book of patient experiences from patients that have been willing to share
their stories… Don’t you think there’d be bias?
I’ll admit that when
we discussed my reaction, I had been a bit confused by his calm reaction. I had
thought: Why don’t you understand why I was offended? Isn’t it obvious that
what the physician said in the story was very rude? How can you not see how the
situation wasn’t handled properly? Is quitting on a client what someone from
the “helping profession” should be doing?? A cacophony of similar thoughts was
bouncing around in my mind when I could see that he obviously did not feel the
same way. I almost regretted bringing it up because it was definitely causing
some tension between us. I have often been told that I don’t recognize the
difference between a discussion and an argument, often turning the former into
the latter. Luckily, our conversation did not get to that point of frustration.
Later on, my friend
said that he didn’t mean to sound so tense from our talk before but that he
often felt that doctors end up playing the bad guy in these stories. Despite
how our education talks about being nonjudgmental and promoting
interprofessionalism, many people walk into an interprofessional setting with
biases about other health care professionals. I began to see that my response to this story
was laden with negative judgment for physicians. Even though my intention
behind sharing my reflection with my friend in medicine was not to be critical
of his profession, it came off that way to him. And I realize that as much as I
was trying to stand in the client’s shoes, I had neglected to think about the
doctor’s position and had formed a judgment on this person based on what is
likely a biased account. It dawned on me that my way of thinking was not as
open-minded or as “OT”-like as it should be. My response should have been more
situation-specific, rather than about pinning a negative judgment on the
doctor.
As much as we learn
about looking at the client from a holistic perspective and being
non-judgmental, my conversation with my friend opened my eyes to how I was
being hypocritical. I had already shared my reflection on this story in our 825
tutorial the previous day, and my emotional response had been more or less
accepted. It had seemed to me that my fellow peers had felt the same way, but
perhaps it was because I was in a room of OTs.
I was very glad that
he brought it up because I had a feeling if neither of us had said anything,
and just left the discussion as it were, there wouldn’t have been closure. I
may be exaggerating here, but I think if it weren’t for him bringing it up, the
lack of understanding would’ve added tension between not only our professional
selves, but between our professions as well.
I told him that I appreciated his criticism on my reflection, and that I
realized that I was being judgmental. It was unreasonable for me to think that
this client’s published story was all there was to their experience with that
physician. This particular experience in sharing my reflection with someone
outside of my program got me thinking in a much broader way than I expected. Not
just about my future occupational therapy practice and how I will engage in
therapeutic relationships, but also how I should think like a non-judgmental health
care professional.
Hopefully, my friend and I do not "outgrow" our friendship any time soon. =)
