During my first day of my Family Medicine rotation I met (in my mind) one of a primary care physician’s most frustrating patients: Andrea (name changed for sake of patient privacy) is a morbidly obese 52-year-old with type 2 diabetes mellitus. She had gained 6 pounds since her last visit three months prior. She had not kept a log of her blood sugars, let alone checked them on a regular basis. She took her medications as prescribed, but continued to live a sedentary lifestyle and eat fast food twice a day. She was incredibly stressed at work and stated she didn’t have time to take care of herself. And, frankly, none of her unhealthy habits really concerned her.
Similar patients presented to our clinic day after day with the same diagnoses and nearly carbon copy routines. In class, another medical student spoke to me and my other classmates about similar scenarios he had encountered. Frustrated, he asked our professor, “How much can a doctor really do if a patient isn’t willing to put forth an effort?”
Our professor, a well-respected primary care physician in the area, responded with something I think will stick with me for the rest of my career.
“We need to empower our patients, not enable them.”
He likened our role to a coach’s at a military training camp. When someone is struggling to climb a rope to get over a wall, it’s our job to give her a boost to get to the next obstacle…but we can’t run for the patient. Similarly, if a patient like Andrea isn’t concerned about monitoring her blood sugars, we can’t make her suddenly transform into a vegetable and fruit eating, marathon running, blood sugar checking superstar patient with a snap of our fingers. BUT when she does come in concerned about her knee pain likely due to her excess weight, she may be more willing to heed our same pieces of advice. We will be more effective (and less frustrated) care providers by meeting patients where they are, by empowering and not enabling them.