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Patient Experience Valuable for Doctors

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In the wake of the terrorist attacks on Sept. 11, Dr. Robert Klitzman was reeling. His sister, who worked at the World Trade Center, died during the building collapse and Dr. Klitzman found himself unable to even get out of bed. His friends and colleagues were convinced he was depressed and implored him to seek help. But to Dr. Klitzman, the pain felt more like the flu.

"I couldn't eat, couldn't work, didn't want to see anyone," he said. "It hurt my body to move."

Eventually, Dr. Klitzman did seek treatment for his depression, and his experiences as both a patient and ailing doctor — he is an associate professor of clinical psychiatry and director of Ethics Policy and Human Rights Core/HIV Center at Columbia University College of Physicians and Surgeons — revealed to him elements of the patient experience that doctors had either marginalized or completely ignored.

His book, "When Doctors Become Patients," addressed similar experiences and revelations by dozens of other physicians whose lives and careers were drastically altered by the patient experience.

Dr. Klitzman recently discussed his book as part of the Division of Medical Ethics Seminar Series held by the Weill Cornell Medical College Department of Public Health.

Dr. Klitzman found that a doctor's primary concerns are often not in step with a patient's, and repeatedly found that doctors who had been patients returned to their work with a clarified sense of compassion and empathy.

One doctor who spoke to Dr. Klitzman about his experience as a patient flew across the country to receive a new, largely unproven treatment for his leukemia, becoming only the second patient to undergo the procedure.

"He told me he probably wouldn't have even considered suggesting that course of treatment to one of his patients, but he didn't think twice about doing it himself," Dr. Klitzman said.

Another doctor who treated her manic-depression with lithium — and who had prescribed the drug for several of her patients — was devastated when she gained 50 pounds as a side effect, preventing her from exercising or enjoying an active social life.

"She said she gladly would have traded some of that weight for some of her symptoms," he said.

Almost universally, Dr. Klitzman found, the patient experience helped shape better doctors — physicians who consider not only symptoms, diagnosis and treatment, but also the dignity of their patients and the mental and spiritual toll their illness take.

The troubling question of "When Doctors Become Patients" — a point that was debated at length during the seminar — is how doctors lose sight of these somewhat obvious concerns to begin with. Does one really have to sit in a waiting room for an hour or wear a paper gown to understand they are unpleasant and often humiliating experiences? Dr. Klitzman asked.

Dr. Klitzman theorized that young medical students are somewhat drained of their compassion and empathy as they advance in their studies. He suggests that patient interaction play an expanded role in medical school curriculum.

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