Ever felt rushed, slighted or brushed off by a physician?
Or that a medical diagnosis was delivered without the proper degree of compassion, concern or respect?
If so, then Dr. Jonathan Weinkle’s new book, “Healing People, Not Patients: Creating Authentic Relationships in Modern Healthcare” (Healthy Learning), should resonate.
A general internist and pediatrician at Pittsburgh’s Squirrel Hill Health Center, Dr. Weinkle recently spoke about the nature of physician-patient relationships to a group of listeners gathered in the Pikesville residence of Rabbis Nina Beth Cardin and Avram Reisner. (The rabbis met Dr. Weinkle last fall while attending a memorial service at Squirrel Hill’s Tree of Life Synagogue for the 11 worshippers murdered by a gunman there in October.)
A Pittsburgh native and part-time instructor of religious studies at the University of Pittsburgh, Dr. Weinkle said he views the practice of medicine as a “gift, privilege and a sacred trust.”
Growing up, he said he originally wanted to become a rabbi. As a result, he said today he strives to practice medicine “Jewishly.”
“We are supposed to liken ourselves to God,” said Dr. Weinkle, alluding to the biblical concept that human beings are created in the image of God. “We weren’t created in God’s physical image, because there is no such thing. But we are supposed to walk after God’s ways, do what God does and imitate God’s performance of loving kindness.”
Dr. Weinkle said the Talmud holds that visiting the sick is an act of loving kindness. But for the visit to have optimal impact, he said the visitor must form a deep and profound healing connection with the patient.
Significant obstacles — some of which pertain to the limitations of the contemporary American health care system — make it difficult for physicians to achieve this goal, said Dr. Weinkle. “Doctors and patients often find themselves working at cross purposes,” he said. For example, he said, “A doctor who wants to keep his patient’s A1C [blood test for diabetics] levels low [may conflict with] the patient wants to eat a nice dinner once in a while.”
Also straining the physician-patient relationship are such matters as overscheduling and the mandates to treat as many patients as possible, while creating enough revenue to keep health care institutions profitable, he said.
But Dr. Weinkle contended that sitting down with patients, listening attentively and genuinely empathizing are the hallmark of the relationship.
He cited the case of one patient diagnosed with lung cancer who insisted that her caregivers were “cancer-bullying” her. She said the medical staff was trying to scare her into following their orders by repeatedly issuing dire warnings about her illness. A social worker who kept encouraging the patient to quit smoking made her feel responsible for her lung cancer.
“Instead of repeatedly telling the patient she should stop smoking when she wasn’t going to stop, the social worker might have said, ‘I can understand why this is frightening. Here’s what we need to do and here’s why we do it,’” Dr. Weinkle said.
Dr. Weinkle recommends that physicians begin every visit by asking about the patient’s chief complaint. Typically, he said, the chief complaint has both emotional and physical components. “It’s rare that the mental and physical [complaints] aren’t intertwined,” he said.
In a subsequent conversation with Jmore, Dr. Weinkle shared the example of a patient who once came to his office complaining of strep throat symptoms.
“I focused most of the visit on strep throat,” he recalled. “After I told her [my diagnosis], she burst into tears. She had somehow gotten the idea she had throat cancer. Once she told me about her fear, we were able to spend 10 minutes talking about what she was really worried about.”
Dr. Weinkle said that some patients are quite demanding or refuse to follow the recommendations of medical personnel. But he said he attempts to find endearing qualities in all of his patients, even the challenging ones.
“One person I’ve been seeing for years was very frustrating to a lot of the people who worked with him,” Dr. Weinkle said. “He has many medical problems that are poorly managed and goes on and off medication because of financial problems. He often gets angry [at caregivers]. But deep down, he’s someone who just wants to be listened to and cared about. He can almost finish my sentences, and that’s something I love about him.”
Dr. Weinkle said he does not aspire to convert all physicians and medical caregivers to his line of thinking.
“If you look at a bell curve, there will always be 15 percent of people on one end who think [what he writes about] is just fluff and completely ridiculous. I’m not going to win over those people,” he said. “The 15 percent on the other end are naturally empathetic and already know how to [treat patients like people]. Then, there are the other 70 percent of people in the middle. I’m one of them. They want to be better at this, but they’re not sure how to do it.”
Dr. Weinkle said he hopes “Helping People, Not Patients” will help colleagues in his field to move closer to their goals of healing those who are ailing and suffering. In addition, he said he hopes the book will help patients advocate for the kind of respectful, empathetic and genuine patient-doctor relationships that they deserve.
For information, visit healerswholisten.com.