[vimeo width=”500″ height=”281″]http://vimeo.com/76899012[/vimeo]
Sue Desmond-Hellman: I’m Sue Desmond-Hellman and I am the Chancellor at University of California, San Francisco. I am an oncologist, a cancer doctor, and I have worked in biotechnology for many years.
MedCrunch: Thank you. You mentioned in your talk previously the emotional EQ. Can you talk a little bit more about how doctors can improve their EQ? Is what can you read or do something you’re actually born with? Is it something you need to have? Is it something that you can try to improve if you don’t have it?
Sue Desmond-Hellman: One of the big challenges we have in medicine is that IQ and EQ don’t always travel together. We often select people because we want our doctor to be smart. I actually want my doctor to have a lot of intelligence and yet there are two things that happen that interfere with developing a strong EQ. I don’t think it is that you are born with it or you never had it, I think that you can acquire more empathy. One challenge is that it turns out that if you are always the smartest person in the room; that can engender some arrogance. Confidence is good; I want my doctor to be confident. Arrogance is not so good. So, it’s not that hard to understand why someone is always the smartest kid in their class and so talented that things come easily to them. They may have just flown through school, got into all the best programs, and are constantly getting positive feedback because people enjoy being around talented people. I enjoy being around talented people. I think that often the feedback that someone gets when they are talented and smart is the opposite of how you develop good empathy. That’s one problem The second problem is that in the past we haven’t addressed this in medical school. We just give people tests and say “learn your anatomy and biology and physiology” and now we are quickly, as early as year one, getting our students to interact with other clinicians, nurses, pharmacist, dentists, other clinicians, and patients. This is something that our school does really well and it really puts you a little bit more in your place. I became a cancer doctor in part because I was so amazed at the patients. I’d wake up and I’d say “Oh, poor me. I’m having a bad day. I’ve got a pain in my arm from playing tennis or… oh, poor me.” As soon as I went on the cancer ward, I started with the theory that I’ve carried since, which is “no whining”. How can I complain when someone is facing suffering cancer -that’s really frightening- and is facing the end of his or her life? The more people have experiences that are humbling, reinforce how fortunate they are, and give them that sense that there really is a human being there the better off we will be. And the more we do that in training and select for that, as we select students, the better off we will be.
MedCrunch: From the other side, how do you think patients can get doctors to treat them better if they are not receiving the treatment that they want, which is difficult for the doctor to give? What can they do to begin to do their part in the relationship?
Sue Desmond-Hellman: I don’t think this is easy. I sort of put this forward for patients knowing that there are some barriers to patients doing that but I’ll just say that for myself -and as I talk to colleagues or my own family- I want to be a good patient. So what does being a “good” patient mean? Well, being a good patient means that I prepare for the physician visit. People often say, “make a list”. The most precious asset that a physician has is time. As a patient, am I using the time with my physician wisely? I am very motivated to do that. So, make a list and get your questions down, particularly the most important things, as I want to use that time wisely. Are there new medicines I have taken? Have I changed my diet? What are the things I’ve done to impact my health that I should let my physician know? I also think that the single biggest gift that anyone gives both their physician and his or herself is to do everything you can to be healthy. Have a healthy lifestyle. Imagine yourself: you went to medical school and you worked really hard. You’ve got all these degrees and now you’re going to be a doctor. You want to be a good doctor, of course and then you see the patient and say “Gee, you might be at risk for lung cancer or you might be at risk for obesity related diseases”. It is really hard, particularly with addicting substances like tobacco or lifestyle choices like being overweight or not really having an affinity for exercising. I would say partner with your physician and really dig into and ask yourself “What am I going to do to be healthy?” Most of all, think of that relationship as a partnership because the good news for patients is moving from this very paternalistic and obedient patient model to an involved patient is that you are going to be healthier and you’re going to get better medical care. The down side is actually some of the illness is on you.
MedCrunch: Of course, patients need to take responsibility. So, you are what some would call a “forward thinking” physician. There are a lot of doctors who are more traditional even though they are doing a good job; they are struggling to adapt their medical culture to current standards. What would be your advice to people that are struggling to embrace this change?
Sue Desmond-Hellman: You are asking an essential and important question. Let me say two things; first of all, far be it for me to criticize any busy clinician. The last thing they need on top of everything else is someone like me saying, “Move into the 21st century”. I reject the notion of criticizing people. If people have behaved in a certain way or have a certain way of practicing medicine that worked for them: wonderful. People don’t do things by accident; they have experienced a different model, a different way of operating. I have many patients in practice that would tell me, “Look, I’m kind of scared by these conversations, can you just tell me what you think I should do?” For breast cancer patients it was often about the choice of mastectomy versus lumpectomy, thinking about radiation, and the side effects. When I was in practice, there were more choices for such patients and some patients felt overwhelmed by those choices. Sometimes they’d like a little bit more direction from their physician. “What do you think?” or, “What would you do if you were me?” Those are kind of scary questions, but I understand why doctors have operated the way they do particularly when it comes to technology, advances in medicine, or patient preferences. Things are changing and they are changing fast.
I guess the thing that I hope for is that physicians use whatever is comfortable for them; if it’s a continuing medical education, if it’s their colleagues, if it’s the medical center they work in, or their physician group self aggregate in any way that’s comfortable for them to make sure that they keep learning. No physician can be a great physician without learning and it turns out today that, in addition to learning more about new medications for arthritis, it might be a new approach to how you track patients, it might be new electronic heath records, it might be new ways that patients want to interact with you, like through email so how do you deal with that and put that in the column of “I need to learn and update myself.”
MedCrunch: If you could say something to all the young physicians that are studying right now, which would be the top tips you would give them as they embark in their life as a physician?
Sue Desmond-Hellman: Well, the first one would be one I wish that I had thought about which is “Relax! Calm down!” We all do this and I laugh because I am certainly guilty as well of the thought that ” I finished medical school with the path to doctordom or whatever that means for me.” I have just had a fantastic experience as a physician. I am so grateful that I went to medical school and that I am a doctor and it didn’t all come easily or naturally but in addition to saying “relax” I would say “Enjoy the day. Enjoy the moment” because it’s not uncommon in academia and in medicine to think you’re next job will be better. Enjoy this job really calm down and enjoy this job. Enjoy your colleagues, enjoy what you’re learning, and enjoy the experience. The second thing I would say is “be flexible.” Don’t worry if every month isn’t on a path to something. First of all, you may not know where you’re going which is very common, and secondly, it might be that one year isn’t your best year but maybe the next year will be better. Don’t expect everything to be this linear path to success. I guess that the third thing is: embrace and enjoy your colleagues. That’s not limited to doctors. In health, some of the best people are working smartest, committed, passionate, take time to enjoy that. It’s really part of what makes it great.