What Makes a Good Primary Care Physician?
As a general rule, primary care physicians like people. This is true long before they start medical school and it continues to blossom during training. Ask these doctors, as I have during in-depth interviews, and they will tell you that certain types of individuals are drawn to primary care careers. So what makes a good primary care physician?
They like to converse with people. They enjoy getting to know details about a person – their ideals, goals, ambitions, cares, and sorrows. They are interested in learning from the patient rather than talking down to the patient. They won’t impose themselves on the patient. They tend to not only want to know the patient but also to understand his or her place in family and society. These doctors want to know the “whole story.” They tend to see the patient as a whole person, as part of a family and community. They see the patient as a unique individual and the patient’s illness as part of that totality of the person, not just a diseased organ or system. Primary care physicians generally like to engage in an intellectual puzzle, with a mystery to solve. They have a “general contractor” mentality, meaning they see themselves as capable of getting most of the job done themselves but are comfortable drawing in others as necessary. In doing so, they are committed to coordinating everyone involved in the patient’s care.
What are the characteristics of a good primary care physician? The deputy dean for education at Yale School of Medicine, Dr. Richard Belitsky, talked to the freshman class a few years ago at their white coat ceremony about becoming a doctor. He told them there was much to learn “but so much of what you need to be really good doctors, you already know…Becoming a great doctor begins not with what you know, but who you are. Being someone’s doctor is about a relationship. That relationship is built on trust…Being a great doctor begins not with what you have to say, but your ability to listen.”
Listening makes a good primary care physician
In my hundreds of interviews, primary care doctors said listening is the key and most important attribute of being a good physician in primary care. This means those who listen to the patient’s story without rushing it or embellishing it. They let the patient develop his or her own story of the situation, sometimes prompting the patient to focus but without unduly narrowing the narrative. The primary care physician must at the same time be nonjudgmental to learn from the patient and develop a strong doctor-patient relationship – the third major attribute. Primary care doctors need to like people and thus like their patients. The good primary care physician is well grounded in basic medical science, the latest in evidence-based care and is constantly seeking continuing education. The good primary care physician is conservative, meaning he suggests changes in lifestyle, behaviors, and other measures such as nutrition or exercise before resorting to drugs or procedures.
This requires patience. Not everything can be “fixed” immediately. These doctors believe that knowing the patient over the long term aids the care process and enhances the doctor-patient relationship. In addition, knowing the patient’s family helps physicians to understand the patient and find an ally in them if needed later. It is important to attend to the patient in the same manner that one would want to be treated by others.
Combined, these measures develop trust, respect, and partnership. As expressed by one primary care doctor, “I need to be available, able, and affable.” Related to this, the doctor must be a good role model, which means exercising, managing stress, not smoking, and otherwise living his or her life in a way that avoids disease and promotes health and wellness.
When Paula Stanziani asked a general audience on LinkedIn what one word describes a good doctor, the answers varied but clustered along similar attributes: listener, commitment, compassion, humanity, attentive, patient, competent, teacher, healer, and ethical. One respondent, Scot Sturtevant, said, “I’ve met many a physician in 36 years of service. Some brilliant, some not so much. The one thing I have noticed though in those that were great, truly great, were those who were humble, but confident. They would listen quietly to a patient’s story and were never really rushed nor found themselves panicking in a critical situation. They were stoic yet responsive, and treated nurses, technicians, and even field medics as a valued part of the team. To sum it they know who they are, and where they came from…And like all of us, still put their trousers on one leg at a time. There really isn’t a single word to describe greatness, it’s part of the diverse nature of who they are and how they apply what they’ve learned and what they know.”