1. What reflections do you have on what you learned or what you now think about the experience of being a patient after watching the movie?

The movie, The Doctor, extensively portrayed the experience of being a patient. Through the movie, you were able to see what the patient-clinician interaction is like from the point of view of a clinician, as well as a patient. The movie starts with the cardiothoracic surgeon, Dr. Jack Mckee, who is making rounds with his interns. It was in this scene that the importance of treating the patient as a person rather than just a disease is ignored. He specifically tells his interns, “…the only job of the surgeon is to cut.” I found this comment very inhumane, as if patients’ feelings are not something of concern for a healthcare provider. Based on my experience working with patients, I find that listening to a patient’s concerns or feelings is of significant importance; it really makes the patient feel like they are being heard. For example, I once dealt with a patient who had a recent death in the family which led them to neglect their own health. I was only able to make the connection between the lack of improvement in the patient’s symptoms and their failure to comply with their current medication regimen because I sat and listened to the patient. In this manner, one learns how to treat a patient on a holistic basis.

The movie also allowed me to reflect on the experiences of being a patient. Although I am learning and training how to be a physician assistant, I still have health problems of my own that need attention; I see healthcare providers just like everyone else. I know from my own experience that I like clinicians who take the time to figure out what is wrong with me and explain every part of the visit. I also like to know that healthcare providers value my time just as I value theirs. After watching the movie, however, I feel that the idea of what is the proper way to interact with and treat patients was reinforced. I just kept thinking about how awful the people would have felt if what I was watching was not a movie but reality. For instance, it really made me sad when June was explaining to Dr. Mckee that she kept revisiting doctors to seek help for the symptoms she was experiencing, and how they didn’t catch her tumor until it was too late; they just kept sending her home with medications that didn’t help. This is another example of why it is important to really get all the information you can get from a patient while taking a history and chief complaint. The physicians in the movie could have possibly found the tumor earlier on if the patient had received better care.

2. Please note specific examples of how physicians treated patients in the movie (how the main character, Dr. Jack McKee was treated and how he treated other patients) – in light of what you now know about patient communication.

There were several instances within the movie when I felt that physicians attended to patients poorly. One example I can recall from the movie is when Dr. Mckee is seeing his first patient who is following up post-operatively. The doctor didn’t really say hi, didn’t introduce himself, or explain what the purpose of the visit was; he just went straight to asking questions relating to her surgery. This way of dealing with a patient is not consistent with the techniques involved in patient-centered communication. Based on what we have learned from patient-centered communication, a healthcare provider should always start by introducing themselves, stating how much time is available for the visit, explaining the goals of the current visit, and opening the floor for any additional concerns the patient may have. Instead of giving the patient the time and space to discuss how she was feeling emotionally – not just physically- Dr.Mckee made a joke when the female patient brought up the concern about how her husband’s fears with her scar were bothering her. I thought the joke was very inappropriate and unprofessional on his part. I think it was his way of shutting the patient up so he could move on with the rest of his day.

Another occasion that I felt could have been dealt with differently was when Dr. Mckee and his interns were following up on the patient who he had been operating on at the beginning of the movie. As part of patient-centered communication, you should always knock on the door and wait for the patient to give you the okay to come in. However, Dr. Mckee didn’t knock on the door to see if it was a good time to come in or ask if the interns could come in as well. From my experience shadowing PAs in the emergency room, I know how crucial it is to confirm with the patient if it is okay to come into the room. The PAs would also have me stand outside the exam room while they introduced themselves and asked the patient if it was okay for me to come in while I shadowed the PA. Patients come to healthcare providers for help and trust them to have their best interest at heart; they divulge their most private information to the clinicians. It is important to make the patient aware that you care about their safety and their privacy, and you do that by asking questions as simple as “can this student come into the exam room?”. For Dr. Mckee, having to come into the exam room and find loved ones at the patient’s bedside was more inconvenient for him than for the loved ones having their space invaded without permission. It wasn’t until Dr. Mckee was sitting in the exam chair as a patient when he realized where his communication and interaction with patients needed improvement.

A quarter of the way into the movie, Dr. Mckee was diagnosed with throat cancer. He had started with a slight itch of the throat and some coughing, and eventually started coughing up blood. The coughing of the blood prompted Dr. Mckee to see a specialist to find out what was going on, it was at this first visit with the specialist that he started to notice how he didn’t like how he was being treated as a patient. What I noticed was how the doctor began her physical examination and didn’t explain anything she was doing. She also didn’t really introduce herself or acknowledge the patient; she just went about everything as if the patient was irrelevant. It was very shocking when she pulled out a scope to check the throat but didn’t explain what she was about to do or give a step-by-step explanation while she was performing the examination. This is another instance that is inconsistent with patient-centered communication. Again, the doctor should have introduced herself, asked the patient what brought him in for a visit, asked about his concerns, stated the goals of the visit, and reviewed the agenda for the visit. She should have also asked for the patient’s consent to proceed with the physical examination and explained what she was doing and the reason she was doing it. Another point in the movie where I feel Dr. Mckee could have been treated better was when he was reviewing the results of his scans with the radiologist. The radiologist told Dr. Mckee that he would have to discuss alternative treatments with the doctor who was handling his care, and it really upset Dr. Mckee that the radiologist didn’t think it was just as important to discuss that matter with him as well. At the end of the day, the patient decides what to move forward with as far as treatment goes, and the patient should be aware of any risks, benefits, or alternative treatments or therapies.

3. In the last scene where Dr. McKee has an exercise for his interns where they have to be in the role of patients:

●  What do you think they would learn from the exercise?

●  How do you think it might make them talk to patients or treat patients differently?

In the last scene of the movie, Dr. Mckee has an exercise for his interns where they have to be in the role of a patient. I think that the idea of this exercise is to teach the interns about what it feels like to be a patient; to learn how to treat the patient as more than just a disease. You gain a different perspective when you put yourself in someone else’s shoes. Sometimes it can be easy to forget that a patient has feelings, and that they need to be treated with extreme care. When patients go seeking medical attention, they might be feeling scared and anxious, and it is important that we address those feelings in the appropriate manner. One way the interns may change their approach to patient care is to acknowledge their feelings and state how they understand why the patient is feeling the way they do and assure them that they will try their best to make it a pleasant experience. Another way the interns’ practice may change is by stating the patient’s name when referring to the patient’s condition or case. Towards the end of the movie, one of the interns referred to a patient by their room number and surgery they had which really bothered Dr. Mckee. Patients deserve to be treated as human beings rather than just a disease. The interns would also learn how to explain any treatments or procedures the patient may undergo so that they fully understand any associated risks or discomfort they may experience, unlike how Dr. Mckee was treated when undergoing his scans.