Friday, January 26, 2018

A Doctor Argues That Her Profession Needs to Slow Down, Stat - The New York Times

Doctors today often complain of working in an occupational black hole in which patient encounters are compressed into smaller and smaller space and time. You can do a passable job in a 10-minute visit, they say, but it is impossible to appreciate the subtleties of patient care when you are rushing.

Enter "Slow Medicine: The Way to Healing," a wonderful new memoir by Dr. Victoria Sweet. The term "slow medicine" has different interpretations. For some it means spending more time with patients. For others it means taking the time to understand evidence so as to avoid overdiagnosis and overtreatment. For Sweet, it means "stepping back and seeing the patient in the context of his environment," and providing medical care that is "slow, methodical and step-by-step."

At the beginning of her book, she relates how her 93-year-old father was mistreated after being hospitalized for a seizure. He is put in 4-point restraints and sedated. Bloody urine drains from his bladder because it has been injured by a catheter insertion. Worse, his rushed doctors don't know that this isn't his first seizure but rather the latest in a long line that can be managed at home.

The steamroller of inpatient care takes over. Every day Sweet's father sees a different doctor. He isn't allowed to eat or get out of bed because he is on tranquilizers. He becomes septic. His symptoms are misdiagnosed as a stroke. Doctors eventually prepare to insert a feeding tube into his stomach because he cannot swallow. Sweet and her sisters get him out of the hospital just in time. When he gets home, he has a steak and a beer.

Sweet writes, "If I, as a physician, couldn't get appropriate care for a family member in a lovely community hospital with well-trained staff — who could?"

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