Eyeworld

December 2016 • Ophthalmology Business 13 that physicians believed it was ap- propriate to self-treat both acute and chronic conditions and that informal care paths were common within the medical profession," Montgomery et al. wrote. Lessons While becoming a patient is never easy, whether you're in the medical profession or not, there are some les- sons that can be learned by doctors and applied to their medical practice. "A lot of these doctors learn things that help them with their patients," Dr. Klitzman said. One, for instance, is how to handle spiritual topics if the patient brings them up. "One doctor told me, 'Patients used to say, Doc, would you pray for me? I'd say, yeah, yeah, but pooh- pooh it. Then I became a patient, and I suddenly realized how import- ant questions about meaning and end of life and spiritual issues are.' In medical school we teach little, if anything about spirituality and religion … but I think these doctors realized what it was to be a patient, which was to wrestle not only with the medical issues of 'Will drug X cure my disease?' but also 'What does this all mean? Am I going to die? Is this the end of my life, if it's a serious disease?' Doctors became more aware of those more human aspects of illness." Doctors who experience being a patient also become more aware of communication issues and how the patient experiences could be im- proved. "One of these doctors, who was a surgeon himself, said the night before undergoing surgery himself, as a patient, his surgeon said to him, there is a 5% chance you may die tomorrow in the operating room. 'It was only later that I realized that my surgeon could have said to me instead, there's a 95% chance that things could go OK.' This surgeon turned to me and said, 'I've been a surgeon for 40 years, and I never re- alized that those two bits of informa- tion that are statistically the same are completely different from a patient's point of view.'" After spending 45 minutes in a waiting room, a doctor might think differently about the patients he or she had previously kept waiting. Experiencing unremitting nausea or fatigue, once perhaps brushed off as annoying but insignificant symptoms before, might take on new meaning after a doctor battles those same symptoms. What about practicing what one preaches? It's easy to tell a patient to eat right and exercise regularly; it's another to do it yourself. "One of these docs who is an endocrinologist said he tells patients every day to eat a diabetic diet—low salt, low calorie. So he decided to try a diabetic diet—he only made it to lunch," Dr. Klitzman said. "Some of them realize that what we preach is hard to follow. Some doctors use their experiences to try to preach it better or communicate it better with their patients." Taking charge Research suggests that doctors who practice healthy behaviors are likely to influence positive behaviors in their own patients. 5 Dr. Goldman said physicians should make sure they are dedicating time for exercise and for their fami- lies, as well as trying to eat healthy, as good first steps at preventative physical and mental health mea- sures. Dr. Klitzman said making sure one has a primary care physician is a good start. He said that while there will always be an element of self-doc- toring among physicians, self-medi- cating should be avoided. "Try to learn from the experi- ence and realize that, unfortunately, when it comes to ourselves, we're not objective. Self-doctoring and self-medicating can get in the way of good care, and we need to be very wary of that." Finally, Dr. Klitzman said his fel- low MDs need to realize that "we're only human." "We have training and can help many patients, but we are fallible and can easily run into the same obstacles that our patients face. We can use that to be better doctors and take better care of our patients," he said. OB References 1. Bruguera M, et al. Doctors taking care of their own health: Results of a postal survey. Med Clin (Barc). 2001;117:492–4. 2. Palabindala V, et al. Personal health care of internal medicine residents. J Community Hosp Intern Med Perspect. 2012;1. 3. Cedfeldt AS, et al. Promoting resident well- ness: evaluation of a time-off policy to increase residents' utilization of health care services. Acad Med. 2015;90:678–83. 4. Montgomery AJ, et al. A review of self-med- ication in physicians and medical students. Occup Med (Lond). 2011;61:490–7. 5. Oberg EB, et al. Physicians' health practices strongly influence patient health practices. J R Coll Physicians Edinb. 2009;39:290–1. Contact information Goldman: drdavidgoldman@gmail.com Klitzman: rlk2@cumc.columbia.edu

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