7 points to look for a good doctor who understands you
By Dr. Naoto Ueno
Perception varies from patient to patient:
Physicians rely on scientific facts when providing medical care, but how patients perceive those facts can vary greatly. This is because their individual life experiences and values heavily influence how they understand and digest the information.
As a cancer specialist, I’ve noticed that even when I explain the same fact to different patients, their reactions can be vastly different. This is particularly noticeable in terminal patients. Despite providing the same explanation, some patients are convinced and feel reassured while others may leave the hospital feeling dissatisfied.
Some doctors do not listen:
Although patients may receive the same information, their reactions can differ greatly due to individual differences. Unfortunately, some doctors may impose a one-size-fits-all approach without taking into account these differences. These doctors may appear to listen, but in reality, they fail to truly see the patient and consider their unique needs.
Three points to identify a good doctor:
To identify a doctor who truly understands their patients, there are three key points to look out for. A good doctor will:
- Speak from the patient’s perspective
- Take the time to answer questions thoughtfully
- Avoid rushing communication
It’s important to note that simply following a patient’s wishes is not always enough. As a medical professional, there are situations where a doctor must provide treatment that may differ from the patient’s preferences. However, I firmly believe that delivering treatment that considers a patient’s values and outlook on life is crucial.
Over the past 30 years, the definition of a “good doctor” in America has evolved. Gone are the days of paternalistic medical care, in which doctors took a more authoritarian approach to their patients.
Making own decisions:
The traditional approach to medical care is focused on providing the most medically optimal solutions, even if it goes against the patient’s wishes, and sometimes patients’ questions are not answered with care. However, the concept of “informed consent” has become more prevalent, meaning patients now have the right to make their own decisions about their treatment after receiving a thorough explanation and options from their doctor.
Patient-centered medicine:
To make the patient comfortable with their decision, doctors must “carefully answer their questions.” In recent years, the concept of “patient-centered medicine” has become more prominent, and it has changed the image of a “good doctor.”
Patients are the focus of our medical practice, and it’s crucial to understand their needs as our customers. “Not rushing communication” means taking time to “listen to the patient’s voice” to grasp their needs.
These three points come from the “patient-centered medicine” perspective, and they all involve the ability of doctors to listen. Today, good doctors listen to patients rather than relying solely on their medical knowledge to convince them.
Two points on explaining to patients:
The trend of “listening to the patient’s voice” or “breaking away from paternalistic medicine” does not mean that doctors should not express their opinions. Instead, it is essential for doctors to convey their thoughts to patients in order to convince them.
I do not believe that presenting patients with the approach of “Here are options A and B, please choose” and giving them enough information is always desirable. As the severity of symptoms increases, the burden on the patient also increases. Instead, it is more effective to say something like, “Based on what we’ve discussed so far, I think it’s best to go with option A. And if that doesn’t work, we can try option B.” This brings us to the fourth point.
- Expressing the doctor’s own opinion
There are rare occasions when a patient wants to make their own choices. In such cases, as long as it is medically feasible, the patient’s wishes are given priority. However, in general, after building trust through the first three points mentioned in the previous section, the doctor will explain and persuade the patient to understand.
Additionally, as we have discussed in previous articles, the world of medicine has many gray areas. It is natural that each patient’s physical condition is unique, and many complex conditions are intertwined. Therefore, the fifth point is:
- Being able to admit when they don’t know something
Of course, as a doctor, it is natural to try to use your knowledge to answer a patient’s question. However, doctors who can clearly distinguish between what is factual and what is uncertain are considered trustworthy. If a doctor says “I don’t know this part” or “the effectiveness has not been proven,” it is not necessary to feel anxious or think that the doctor may not be reliable. After all, medicine has only developed to a certain extent.
Paternalistic doctors who believe that patients should just listen to what they say may find it difficult to admit when they don’t know something. Conversely, doctors who can admit when they don’t know something are more likely to be patient-centered. Furthermore, if a doctor is willing to think together with the patient until they understand or consult with other medical professionals when they don’t know something, they become an even more valuable presence.
Two Points to Consider When Disclosing Information:
Aside from the examination, it is possible to discern whether a physician is patient-centered or not from their overall demeanor. Without further ado, here are the sixth and seventh points:
They give you a copy of your medical record.
They allow you to record the examination.
What we can measure here is whether the physician recognizes that patient information belongs to the patient themselves. As mentioned earlier, patient-centered healthcare has developed in the United States to the point where these two points are performed routinely and physicians cannot be differentiated. Patients can access their medical records anytime using an application on their smartphone. Since a mechanism has been established for sharing patient information and medical records, physicians do not even need to make copies of the records. However, in Japan, digitalization is delayed, and patients may be denied the sharing of their medical records.
It is not certain whether the healthcare institution or the physician is refusing to share the records, so it is hasty to link this to the physician’s individual qualifications. However, since the Personal Information Protection Law stipulates that medical institutions must respond to the patient’s request for disclosure of their medical records, even if the request is refused, it can be considered as effective evidence for discerning whether the physician is patient-centered or not based on how they act afterward.
Many of my patients start recording the examination as soon as they enter the examination room. Some even begin filming, but of course, I do not stop them. All information belongs to the patient.
Furthermore, requesting such recordings or copies of medical records can also lead to physicians exercising their self-control, which is a benefit to patients. It becomes an incentive to provide medical care that is not embarrassing no matter who sees it. There may not be many doctors who cannot provide appropriate medical care without a camera, but I think there are many doctors who speak more politely, so please actively record conversations with your physician.
*Please see and ask your doctor about your cases. This article was created from various reference sources as a gate to multiple helpful pieces of information. Please refer to the original articles for more detailed information.
Source:
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ロサンゼルス在住のIT技術者・AIを駆使したソーシャルアントレプレナー。製造業IT戦略、コンサルティング（ベイン＆カンパニー、デロイトトーマツコンサルティング、楽天）を経て10年前に渡米。現在はITコンサルやスタートアップに注力。豊富な経験をもとに、AIビジネスや最新のトピック、ビジネスのコンテンツなど、さまざまな雑感をブログで発信しています。
BPPV (良性発作性頭位めまい症)の克服記録
英語でBPPV (Benign Paroxysmal Positional Vertigo)、日本語で言う良性発作性頭位めまい症にかかりました。多くの人が困っている病気であり、私の経験が少しでも役に立てばと思い、記録を残します。
背景
現在アメリカでIT関連の仕事をしています。主にオフィスに通勤していますが、このことがBPPV（良性発作性頭位めまい症）中に大きく影響しました。ある土曜日、久々に大きなプロジェクトが終わりました。このプロジェクトは短期集中のもので、非常に大きな期待とプレッシャーを抱えていました。私はほっとして庭でステーキを焼きながら普段飲まないお酒を飲みました。翌日の朝、ひどい二日酔いだと思ったのですが、今から考えるとBPPV（良性発作性頭位めまい症）の症状が出ていました。
初期の対応
翌日は明らかにBPPV（良性発作性頭位めまい症）の症状があり、会社には連絡してリモートで仕事をすることにしました。同時に風邪をひき始め、喉や鼻の調子も悪化していきました。BPPV（良性発作性頭位めまい症）によるめまいは治まらず、特定の動きをすると地面がグルンと動くような感覚がありました。急に顔を動かすとめまいがし、運転はできない状態でしたが、座ってPCを見ているときはあまり気になりませんでした。長時間仕事をすると症状が悪化することも分かりました。
医療機関への訪問
1週間後に病院に行きましたが、喉の腫れの影響だろうと言われ、病名はつきませんでした。さらに1週間後、再度病院に行ったところ、耳の中の石（耳石）がBPPV（良性発作性頭位めまい症）を引き起こしている可能性があると言われました。フォローアップの文章には「BPPV (良性発作性頭位めまい症)」とあり、エプリー法という対処法が載っていました。
自己対処
様々な方法を試しましたが、エプリー法はあまり効果がありませんでした。私はプールやジャグジー、サウナ、軽い筋トレを行い、血流を良くすることに努めました。特にプールでの平泳ぎがBPPV（良性発作性頭位めまい症）の症状改善に効果的でした。また、日本のサイトや東洋医学の先生のアドバイスを参考にし、運動不足や肩こりがBPPV（良性発作性頭位めまい症）の原因であると考え、対策を続けました。
エプリー法が効かないと感じた私は、NHKの「耳石崩し体操」の方法を試しました。この方法は、首を特定の方向に動かして耳石を散らす方法で、BPPV（良性発作性頭位めまい症）の症状に対してこちらの方が効果的でした。
回復期
発病から3週間経つとBPPV（良性発作性頭位めまい症）の症状が少しずつ改善し、4週間目にはリモートで働き続けました。BPPV（良性発作性頭位めまい症）の症状が6から5程度に下がり、2ヶ月経った頃にはほぼ日常生活に支障がない状態にまで改善しました。1ヶ月半ほど経った時点で専門医に診てもらい、私の対処法が正しいとお墨付きをもらいました。
総括
なぜ耳石が剥がれたのかは分かりませんが、運動不足、ストレス、風邪の初期症状などが要因でBPPV（良性発作性頭位めまい症）を引き起こしたのだと思います。運動と血流改善がBPPV（良性発作性頭位めまい症）の克服に非常に有効でした。特にプールやサウナ、軽い筋トレがBPPV（良性発作性頭位めまい症）の症状改善に効果的でした。また、ヨガのような首を動かす運動もBPPV（良性発作性頭位めまい症）の予防に最適だと思います。
私は運動習慣をつけることで、血圧が安定し、健康状態も改善されました。BPPV（良性発作性頭位めまい症）になって学んだのは、睡眠環境の重要性です。自然に寝返りを打てる環境を整えることが大切だと感じました。
歩行中のめまいの症状 歩いているとき、BPPV（良性発作性頭位めまい症）によるめまいは非常に厄介でした。特に、地面が不安定に感じられることが多く、足元がふらつくような感覚がありました。歩行中に急にめまいがすることがあり、その際は立ち止まって目を閉じ、深呼吸をすることで対処しました。これにより、BPPV（良性発作性頭位めまい症）の影響でバランスを崩すことを防ぎましたが、完全にめまいを防ぐことは難しかったです。外出時には杖や手すりを利用することで、安全を確保しました。
詳細な対処法 BPPV（良性発作性頭位めまい症）の原因となる首の動かし方を特定し、それぞれに対処するために、A、B、C、Dパターンと呼んでいました。具体的には、
- 首を右に傾けてまっすぐに戻すAパターン、
- 頭を最初に左に傾けて鏡で顎の下を見るようなBパターン、
- 左に首を45度傾けて前後に動かすCパターン、
- 左に顔を向けて首を右に捻って顔で上を見るDパターンです。
これらの方法を試行錯誤しながら実施し、各パターンが改善されると次のパターンに進むようにしました。発病後2週間からこの方法を続け、最終的には全てのパターンでBPPV（良性発作性頭位めまい症）の症状が改善されました。
最後に
私の経験から言えることは、運動と血流改善がBPPV（良性発作性頭位めまい症）の克服に非常に有効であるということです。また、BPPV（良性発作性頭位めまい症）の予防にはヨガや適度な運動が効果的です。多くのIT技術者や画面に向かう仕事の方々にとって、運動習慣の重要性を認識していただければと思います。