2017 Medical Ethics Seminar

Why We Should Listen: Patient Satisfaction, Burnout, and Ethical Medicine

Friday, September 8, 2017
6:00-8:30 p.m.
Banquet Hall, 5th Floor, Cashion Academic Center
Cost: $95 (includes meal, presentation, and 1.75 AMA PRA Category 1 Credits^TM with ETHICS and/or PROFESSIONAL RESPONSIBILITY designation)

Description

Two of the most common concerns in contemporary medicine are patient satisfaction and physician burnout. Both patients and physicians have a sense that something important is missing in the practice of good medicine, and no one is happy about this.

There are aspects of the medical system that cannot be changed, at least in the short term. Rather, our concern is how to approach the day-to-day practice of medicine in a way that recovers some of what has been lost, even if the system as a whole does not improve. A beginning may be made by rethinking the role of imagination and storytelling in the patient-doctor encounter. This presentation will argue that mindful listening is at the heart of what is meant by “the ethical practice of medicine.”

Hearing the patient’s story impacts the practice of medicine in several ways:

It highlights aspects of the patient’s world-view that contribute to decision making when the biology alone does not answer the question about what to do next (an example is the patient with relapsed cancer who is faced with the choice of whether to take a new treatment or to spend her time in some other way besides taking medicine)
It underscores the importance of being curious about patients’ perspectives when helping them make decisions that affect their lives.
It suggests the importance of re-arranging the way that time is spent in a clinic visit in order to allow 1-2 minutes in which the physician quietly listens to the patient’s answer to the question, “What are your concerns today, and how can I help you?”
It suggests that among the skills a physician must develop is the ability to sense when there is a lingering, as-yet unspoken concern on the part of the patient – a skill that requires the development of something akin to ‘mindfulness’ and the old virtue that used to be called ‘prudence’ (which was understood as a capacity to see the truth of a situation).
It suggests that one reason William Osler thought physicians should read literature is to gain insight into worlds that are different than their own, growing their ability to imagine views of reality that surprise them, but that are important for understanding decisions that fit the patient in front of them.

Drawing on his experience as a pediatric oncologist, Dr. Raymond Barfield will argue that a couple of minutes spent listening to a patient with genuine curiosity, mindful attention, and imaginative reach leads to better decision making, fewer unnecessary tests, greater patient satisfaction, and a deepening of the physician’s own sense of vocation. He will also argue that it is simply false, in most instances, that listening in this way takes too much time – indeed, it can actually save time, because often patients will give the physician clues in the course of telling their stories that lead to more efficient, effective, and ethically sound medical practice.

Objectives

Be aware of the causes of patient dissatisfaction and physician burnout.
Recognize the languages often used in medicine and how these languages can often hinder physicians from understanding the experience of illness for the patient.
Acquire skills for incorporating time for listening into patient encounters to allow opportunities for hearing unexpressed concerns or fears that might help shape treatment options.

Accreditation Statement:

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Texas Medical Association and McLennan County Medical Society. The Texas Medical Association is accredited by the ACCME to provide continuing medical education for physicians.

Designation Statement:

The Texas Medical Association designates this live activity for a maximum of 1.75 AMA PRA Category 1 Credits™ with ETHICS and/or PROFESSIONAL RESPONSIBILITY designation. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Evening Schedule

6:00-6:45 Dinner
6:45-7:45 Presentation--Dr. Barfield
7:45-8:30 Q&A with Audience

Speaker

Raymond Barfield, M.D., Ph.D.
Associate Professor of Pediatrics and Christian Philosophy
Duke Medical School and Duke Divinity School

Dr. Barfield joined the faculties of Duke’s Medical School and Divinity School in 2008. He previously served at St. Jude Children's Research Hospital, where his research and practice focused on improving immune therapies for childhood cancer and understanding the moral aspects of decision-making in medical research involving children. At Duke he has turned much of his effort towards bridging activities in theology and medicine. He continues to practice as a pediatric oncologist, and he directs the Pediatric Quality of Life/Palliative Care program, a program that combines medical care, education, and research to benefit children with complex, chronic, or potentially life-limiting disease.