Dear Lucy,
This is in reply to your "Dreams and Reality (to go on)" in which you asked for "support", "inspirations", "criticism".
This description of my physician may give you some ideas about how you can control your practise so that you can still have a varied life, using your creativity in your practise, make your living, and become loved and trusted by your patients because you know them, and have helped them.
In Canada, patients come to their doctor's office after phoning for their appointments, which are given quickly within hours if the need is great, the same day or the next, if less need, or in a week. Specialists often have waiting lists and you may have to wait a long time, (months). No doctors here make home visits except in the most extraordinary circumstances. And maybe not even then. If you are in real trouble you are expected to call Police/Fire/Medical line 911, request an ambulance and be swiftly taken to the hospital emergency department.
My physician is so extremely efficient that it is a pleasure to be his patient. I know I'm going to leave my home, be in his simple office in less than five minutes, and in twenty minutes, or at most 3/4 of an hour, I am going to be back home again. I have often waited for an hour or two in some of my other family doctors' offices, and at best regularly hadto wait for a half hour to see them.
I think this is how he spends his week: one day he sees his geriatric patients in an old people's home nearby, and he doesn't open his office that day. He must make hospital rounds in the mornings to see his patients in the hospital in town. On some Saturday mornings he is in a clinic near his office where he removes possibly dangerous skin moles, etc.
He likes sports and sports medicine, and travelled abroad with one team as the team doctor. He is clearly interested in fine art, as I can see from the artistic choices on his walls. One is similar to a Dali, another is a type of sand painting. I'm a trained artist, and a visual person so I notice these kinds of things. Once I mentioned that I'm a visual and he said he is, too. Maybe that's part of why he is a good diagnostician.
He always has classical musical playing throughout his office and examining rooms. It comes from CBC FM2, which is the government radio station which broadcasts all music with a little news. I think the music helps him, and also us. Once my blood pressure was very high. He dimmed the lights. Told me how to slump back relaxed and to concentrate on the music while he saw another person and would be back in ten minutes. When he returned he took my BP again. Of course it was somewhat better. I thought that was creative, compared to all other doctors I've seen.
All of his equipment is all laid out in exact order, everything the same, and in the same order in each of his three examining rooms, set to be immediately ready to hand. His nurse/secretary keeps someone in each room, waiting, so he moves immediately on from one to the next. (After washing his hands if he touched a patient, of course.)
He quickly refers you to specialists, as needed. Thus, you get the treatment you need early, instead of after years, as has happened to me often enough before with doctors who dished out far too many antibiotics to me, and didn't stop to think why a young woman should be sick so very often, over so many years. At that time I wasn't well enough, to do anything more than accept it, although I knew things could be different because twice in my life I had been cured of it for a few years by doctors who took the time and effort to think, and to care.
He is crisp and efficient. Some people think he doesn't have a "good bedside manner" because he tells you directly what the trouble is without pussy-footing around. I personally prefer that. One of my friends was in hospital, and noticed that he is respected, and people don't want to fall short in taking care of his patients. His very attitude would make them feel that way. He also seems to be able to assess your way of being, quickly, and apply it to his diagnosis and give some tips about how to manage yourself. I like that very much and am a cooperative patient. Although I have read that 80% of people don't even take their prescribed medications. That must be discouraging for a physician. I think he wouldn't hesitate to be outspoken about it if someone did that.
I can see that a *lot* of thought has gone in to making his practise stream-lined and efficient.
He takes vacations. Then a locum comes to take care of his office.
I think he's a role model, because he has a balanced life. He is lean, and looks as though he is healthy and may be a skier. He's not young. Probably 50 or 60, and doesn't smoke.
When I had to find a new physician because mine suddenly became ill, I consulted the hospital list of physicians accepting now patients. There were six. I found that this one was the family physician of a friend whose judgement I trust, and that this doctor also had his practise near where we live. When I phoned for an appointment after consulting my friend about him, I learned that I could only become his patient if I lived in this area. Fortunately I did. I don't know where he lives, but I expect he lives somewhere in this area, too. His secretary/nurse lives nearby. The home for the aged here is where his geriatric patients live. So everything is close for him.
He has a little desk attached to the wall in each examining room and your file is waiting there, placed by the secretary who also quicklyrefreshed the examining table and anything needing it, after the last patient, and then ushered you in. Each room seems to be in use all the time. He stands at the little desk where the prescription blanks, and all papers he needs are there in compartments. I have never seen such an efficient person or office.
He never gives a prescription with repeats. Rather, he prescribes enough for three months, and then you must come back for more if you are a person with chronic problems. He likes to see how many are left in your prescription bottle (which you should bring in with you) and then will order enough for the next three months. Therefore, you see him a minimum of four times a year if you have a chronic problem. If not, you only go for a yearly visit. If the problem is acute, he will probably see you again in a week, then two, till you're better. By not giving repeating prescriptions he keeps track of exactly what his patients are taking. Many doctors don't do so, and often patients end up taking conflicting medications, and too many of them, for too long a time.
I commented on his efficiency to his secretary, and she gave me a meaningful look and said, "You'd better believe it!"
So, I think that you may be able to get some ideas of how to make your practise work well for you as well as for your patients, if you find any of this applicable to circumstances in China.
He answers any question briefly and well. He will take time when needed, but otherwise he is in, observes, makes notes and out of the examining room in 5-10 minutes, and the nurse makes any further appointments you need, and your're off, and on your way home.
I think medicine is an art, because of the art and inspiration needed in good diagnosing. It could also use more of the art of psychology on the part of physicians here, I think. It would help the healing in patients.
Far too few physicians seem to think about how to use the fact of how important they are to their patients for the benefit of the patient. They have so much power and influence in their patients' lives. They should make more use this to help the patient's confidence, so that the body will assist more in healing itself. Encouraging words to patients about their progress should be very common. Telling the patient about condition, is another excellent thing to do. It will help the patient to expect that it will also work for him, and the "placebo effect" will come into action to give the doctor's genuine medicine (not a placebo,) double effectiveness.
I think this is what the witches, shamans, and other healers of this type do. They use psychology and artistry along with their often good folk medicines to bring great influence on patient to expect to be healed. Probably even some of their poorer treatments still act as placebos, and so often have beneficial effect. You, a medical doctormaking use of some of this power through your words and behaviour, and doing this without the dark part of superstition would be a great thing, if it is possible. The white coat and stethescope alone are as much of a power costume as any witch doctor's regallia.
Unless you really don't like Medicine, I think you should do your best to continue and graduate, and see what you can achieve with it. You will know better whether you should have your own thesis printed or arrange for them to do it. My daughter's Master's thesis in Geography, on Foucault, is still listed in the internet for anybody who wants to access it for their own research. Maybe theses of you doctors are also made available to other researchers?
You may find other ways than I've described to bring your artistic abilities into your practise. If all else fails, there is still the specialty of "art therapy", and diagnosis of people through their drawings. You might want to specialize in that. It would complimentyour medical degree and entail your learning and making art yourself during your studies. There is good training for Art Therapists in Montreal, Quebec, Canada.
This post is to offer what I have observed my physician do that has made his practise controllable. I think this would leave room for you to have the other activities you love in your life, and also include some aspects of acting and psychology, perhaps music and so on into your practise of medicine.
I hope this may be of some use.... or of some interest to others.
Warm regards, Mary
