The Fastest DX in TX

“The good physician treats the disease; the great physician treats the patient who has the disease.”

-          William Osler

The following is a story told to me by David Dworski, my colleague and good friend:

Consider This

My college class has a reunion every 5 years. When I went back for the 15^th reunion, I ran into an old friend who had gone to medical school and established a very prosperous practice in Texas. He went to great pains to tell me how successful he was, how fast a diagnostician.

“Patients come into my exam room” he said, “and in 60 seconds I can tell ya’ what they got… I am the fastest DX in TX.”

I was amused by that. I thought that was kind of terrific, he must be quite a scholar.  We ran into each other 10 years after that, at our 25^th reunion. We sat down again to renew acquaintances, and I said “Are you still the fastest DX in TX?”

He kind of sobered up, and replied “No, I don’t play beat the clock any longer. I had a near miss; there was an adverse effect, and I almost lost a patient because I was too quick on the trigger. I learned an important thing, and I stopped trying to be faster than a speeding bullet in making diagnoses. It made patients feel it was incumbent on them to repeat their story because they didn’t believe I got it the first time, or seek a second opinion, because I might not really be listening. Having nearly lost a patient, I decided I had to take my time and listen to the patients’ stories, ask a few questions to flesh things out, and then make my diagnosis. My clients feel more confident about my skills these days, and so do I.”

Working in healthcare, that was an important lesson for me.

“We are dealing with individuals who are scared and uncertain. They can’t tell if you are a good caregiver or a bad caregiver. What they can tell is: are you kind? Are you listening?”

-          Harold Krumholz, Yale School of Medicine

The Take Away

Being a physician is not a timed event – there are no medals for fastest diagnosis. Don’t sacrifice excellence in the name of speed. It is more important to listen to the patient, make them feel heard, and remember that they are a person, not just a disease.

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