Many physicians studying, training and independently practicing medicine today have questioned the future of their profession. I am no exception to this. At the worst times of my career, I cannot escape the growing unease of feeling like another cog in the wheel. Fortunately, these times are few and far between in a very rewarding career as a clinical doctor.

Despite these challenges, physicians must understand that there are a few unique abilities that will stay constant and should never be underestimated when gauging our professional worth:

The ability to cure.

The ability to palliate.

The ability to heal or hurt with the power of our words.

I had never contemplated this last capability as much as I have in this past year.

It started with a phone call that no one wants, and, ultimately, everyone gets. A loved one is sick in the hospital with an uncertain diagnosis and prognosis. In that instant, I was stripped of my medical profession, only to be recast as just another concerned family member of an ailing patient.

Sticking to this new role, I did what any worried family member does when faced with such fear and uncertainty: I sat there at bedside and hung on to every word reported by a series of physicians. I stared at the expressions of every medical team entering the patient room, searching for confident smiles, furrowed brows -- anything that I could translate as an unspoken update.

There were so many words and so many expressions.

One medical team would come in with reassuring news: These signs/symptoms are probably due to an idiopathic blip that would heal quickly.

Another team would then follow with a conflicting update: More data is needed and we cannot comfortably tell you that this is not what we are all worried about.

One attending physician would stop by daily, even after he went off service, to keep us all updated on the amazing recovery we are seeing with our very eyes. These uplifting sermons occurred even as a series of major complications shot serious holes into his prognostic guesswork.

I cannot confidently say that I've learned anything by being witness to the prolonged suffering of a loved one. A large part of me feels that truly sad and tragic events remain exactly as that, unable to be shape-shifted into a series of life-long lessons.

However, I have come to appreciate the unique power that only a medical provider wields when communicating serious illness to a patient and his or her family.

Effective patient communication is a distinct and deliberate skill-set that physicians must take seriously when considering their role as a clinical provider. We should always stay cognizant of this emotional influence when updating patients and their families during the course of a complicated hospitalization.

Clinicians caring for the same patient should meet often to avoid conflicting dialogues that only result in confusion, as this only provides more distress to an already inconceivably difficult time. Medical students and residents should be taught early and observed longitudinally on their effectiveness in communicating serious illness and medical uncertainty.

Just like a medication or procedure, doctors' words have the ability to treat and to complicate. As such, clinical physicians should be as competent in patient communication as they are in any other aspect of direct patient care.

Originally written for LeadDoc.
Brian Secemsky, M.D.

Medical writing for patients, students
and practitioners.

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