WASHINGTON (Oct. 4, 2017) — The doctor-patient relationship is the cornerstone of quality health care. At a time when divisiveness and racism seem at the forefront of every news story, both doctors and patients must learn to overcome prejudices, no matter their backgrounds and beliefs, in order to create a true path toward healing.
These reflections and more are included in a Narrative Matters essay published in Health Affairs, authored by Raya Elfadel Kheirbek, MD, associate professor of medicine at the George Washington University School of Medicine and Health Sciences and internist geriatrician and palliative care physician at the Veterans Affairs Medical Center in Washington, D.C.
Kheirbek describes one particular experience treating a veteran who had asked her to switch doctors based on a mistaken belief that his previous physician of Indian descent was from the Middle East. As a Syrian American, Kheirbek struggled with how to broach the topic, leading to an examination of her own prejudices.
“I realized through this experience that there are perpetrators, and there are victims, but often, both coexist in one mind, an entanglement that is complex and often misunderstood. They are less mutually exclusive than I previously thought,” said Kheirbek. “I know what it is like to have stereotypes of my own, as well as what it is like to be discriminated against. And so do my patients. I hope an admission of vulnerability in revealing my truest self will help my physician colleagues open the door to an honest conversation about compassion, empathy, and true understanding of our shared humanity.”
“In war, innocent people suffer. There are no winners, only losers. All risk in fighting, and ultimately, all lose on a risk that, in most cases, wasn’t worth taking in the first place,” said Kheirbek.
The essay touches on the importance of attentive listening, and making that a priority in the exam room, in order to connect with the patients, to allow them to be heard and to honor their lived experience.
“We have an obligation to care for all our patients equally. The Hippocratic Oath does not have stipulations,” said Kheirbek. “The discriminatory patients might be most vulnerable. The fact that they are coming to their appointments indicates their need for help. In that very moment we should practice and model tolerance, respect, open-mindedness, and peace. After all, the present moment is all we have”
The Narrative Matters essay, “At the VA, Healing the Doctor-Patient Relationship,” is available at Health Affairs.
