Download as a PDF

Technology is fine, but doctors need to pay more attention to their patients, Dr. Abraham Verghese said April 27 in Bozeman.

Speaking at the Cafe Scientifique lecture series, Verghese said physicians shouldnt turn to the computer when asked how their patients are. Instead, they should focus on their patients and listen to their stories and feelings. They should observe bodies more than machinery.

Verghese, a pioneer in medical humanities, wrote the best-selling book, My Own Country: A Doctors Story. He was born in Africa, completed medical school in India and came to the United States for a residency in internal medicine and a fellowship in infectious diseases. He lectures throughout the world about the importance of humans over medical technology.

Technology is valuable, but good bedside skills can enhance technology, Verghese told the crowd that gathered to hear him discuss The Missing Patient.

They still need someone on the front line examining them, touching them, Verghese said about those patients.

Verghese said he gained a reputation for treating patients with chronic fatigue, and hes convinced it came largely because he spent time with them. Hed first schedule an hour-long appointment where the patients did nothing but tell him their story and present the finds of previous doctors and clinics. Then hed schedule a second appointment where hed examine the patients as intensively as possible.

I did the most thorough exam known to man, invoking every maneuver known, Verghese said.

After that, he would tell the patients everything he had heard and learned, reassure them that the problem wasnt in their head and suggest a course of treatment. Because the patients were convinced he had heard them, they were calmer and more willing to hear his recommendations, Verghese said.

I was always convinced the only thing I did differently was the exam, Verghese said. It allowed them to take from me what I told them.

Reviewing the history of medicine from Hippocrates to stethoscopes, Verghese said physicians in the early 1900s were geniuses at bedside treatment, but that ability began to decline in the 1970s. These days, he said, Theres a present malaise in medicine. I believe our patients are dissatisfied with medicine the way we practice it despite the fact that we have never had more technology, more treatments.

Hippocrates was a great observer of the body, and observation dominated the medical scene for the next 600 years, Verghese said. Intervention was rare. Finally came percussion, the tapping of the body to listen for enlarged organs and fluid in the lungs. Later came the stethoscope, which was a very, very important moment in medicine.

The stethoscope represented the separation of physicians and barber surgeons, Verghese said. Before that, medical treatment often involved bleeding, which was done by barbers.

Stethoscopes showed that there was somebody who would try and decide what was wrong with you and give you appropriate treatment, Verghese said.

He didnt mean to condemn modern doctors by making broad statements, Verghese said during the question-and-answer period that followed his talk.

Theres no doubt technology is very good for certain things, he said. Im not arguing that.

Asked to give advice to medical students, Verghese said he spoke earlier to students in the regional medical program known as WWAMI and told them to follow their hearts when picking a specialty.

Worry less about lifestyle, he said. Follow what you can be passionate about for the rest of your life.

By Evelyn Boswell

 

The Café Scientifique was co-sponsored by Montana INBRE and Montana State University COBRE programs.