This 20-year veteran of family medicine says she believes patients want professional closeness, not professional distance. She believes closeness can be done appropriately-and that it should be done.
I started kissing patients in med school. And I haven't stopped.
During my third-year pediatric rotation, I would stay up late at night in the hospital, holding sick and dying children. I'd lift them from their cribs, kiss them, and sing to them, rocking them back and forth until they fell asleep. One day the head of the department pulled me aside. He told me that I was a doctor when my patients needed a doctor and a mother when they needed a mother.
Twenty years later, I'm still mothering my patients.
I'm a family physician born into a family of physicians. My parents warned me not to pursue medicine. They thought big government would kill America's small-town neighborhood doctor. But I love being a family doctor. And I love my patients. I hug them and kiss them, and I do house calls. And most patients call me Pamela or sweetie or honey. They all have my home phone number. I'm on call 24/7, but I never feel like I'm working.
I guess I'm never really sure when work ends and play begins. It all feels the same to me. Many of my patients are friends. I do their physicals and go to their homes for dinner.
Doctors are warned to maintain a professional distance from patients. But how can I remain distant when I'm looking deep inside people in places nobody has been before? How can I remain detached when delivering a mother's first baby, saving a sister's only brother, or helping a child's favorite grandfather die?
I've been told that maintaining a safe distance from patients will help my objectivity, limit favoritism, maintain clear sexual boundaries, and prevent exploitation. But patients today don't want professional distance; they want professional closeness with a doctor who has a big heart and a great love for people and service.
And I strive to be that kind of doctor.
I'm the kind of doctor who once hired a patient-a massage therapy student-to work on low-income, high-needs psychiatric clients during their medical appointments. All enjoyed free foot baths and hand rubs. Not one had ever received massage-most had never experienced safe, loving touch in their lives. Now they require less medication.
I'm the kind of doctor who believes in favoritism. I want every patient to feel like they're my favorite. So I celebrate random "Patient Appreciation Days." Yes, I shower unsuspecting visitors with dark-chocolate hearts and Mylar smiley-faced balloons as they enter the office. This is in addition to the gifts many receive for meeting their health goals. Sitting on the couch next to her balloon, treats piled high in her lap, a woman bursts out, "This is like going to Grandma's!"
Kids and adults alike enjoy the unexpected attention and gifts. It's especially exciting for new patients who choose me from a preferred provider list given to them by their health insurance company. After receiving a door prize and an initial hour-long appointment, one gal exclaims, "I feel like I hit the lottery!"
That's exactly how I feel being a family doctor. Best. Job. Ever.
Doctoring, like mothering, is a subjective experience. Good doctors are interested, friendly, and intuitive. Patients don't seem to want objective doctors who are impersonal, unemotional, and strictly business.
Doctors, like mothers, should be emotionally intimate. And they should maintain clear sexual boundaries like any good mother does with her child. Maybe doctors should be more motherly.
A few years ago I visited the foster home where my nephew lived before he moved in with me. I spent the weekend with a dozen teenage boys, all on psychiatric medications. An autistic child had moved into the home that day. At nightfall, he begged me to tuck him into bed. That evening I tucked all 12 boys into bed and kissed them goodnight. When the foster mom found out she said, "You crazy. Them boys hasn't been kissed in years!"
Maybe some patients don't need a pill. They need a kiss.
Pamela Wible, MD, is a family physician who founded the first ideal medical clinic designed entirely by patients.