I’ve been noticing recently that the most important thing I can do in clinic is listen respectfully and come up with a shared plan that feels like the patient owns it at least as much as I do.  When it goes well it almost feels like I’m handing out a prescription for respect.

Looking through this lens, I see respect as the critical currency in most of what we do, whether it’s doctoring, collaborating with colleagues, parenting, or teaching.

This year, our daughter’s 3rd grade teacher is probably the best elementary school teacher we’ve ever met.  One key to his success: every morning as the kids line up to enter the classroom, he individually looks every kid in the eye, shakes their hand, and genuinely asks them how they are doing, how was their weekend, or similar.  What does it mean for an 8 year old to have a respected grown man take them that seriously everyday?

When things aren’t going right with someone at work, or with my wife for that matter, it seems like it’s always a good idea to remember to ask myself: does the other person feel like they’re getting enough respect from me?  These relationships are obviously more complex than this, but I’m finding this simple framing helps me better understand others’ perspectives.

While I can’t prove it, I’m willing to bet that a prescription for metformin accompanied by an extra dose of respect results in better adherence and outcomes.  What does respect mean in this context?  This is definitely a work in progress, but I think it includes:

  • Introducing myself as “Roni Zeiger, one of the doctors here” instead of “Dr. Zeiger”, a tip I recently stole from Otis Brawley after reading his book, How We Do Harm
  • Asking the patient what he or she thinks is wrong; I explain that I find patients often know what’s wrong or their ideas provide useful clues
  • Explaining that the diagnosis and/or treatment we agree upon might be wrong and how we’ll learn that if that’s the case

In this context, respect means I’m interested in your perspective and it matters, we should collaborate, you are part of the solution.

Here’s to prescribing more respect and more sincere collaboration with patients.