What color is your lab coat?
In this case, the question posed is rhetorical, so don’t answer it. In all reality it doesn’t matter what color lab coat you wear; black, white, or no lab coat at all, since it’s a metaphor.
The doc’s persona in the treatment room is that of the white coat… the pure and noble practitioner, working only to do good for humanity (or animality, I suppose), help their patient, and carry on with their life of servitude. Right?
This is, as we all know, complete and utter bullshit. The doc’s job in a room is to get results! And since you can’t always guarantee results, you’d better be comfortable with a little thing we call honesty. Look it up, it’s a word.
I know, I know… you aren’t one of those practitioners. You tell it like it is, ya?
Just for giggles, let’s say you have a patient suffering chronic bilateral plantar pain and complaining of an inability to lose the excess 134 pounds he’s put on since quitting the wresting team in college, although he has taken a keen liking to WOW, Fringe (oh yeah, I love strange TV), and Doritos.
White coat says what?
Yeah. Wrong answer. And actually, a trick. You see if you get this one right you’re wearing the black coat over top of the white one. If you get it wrong, well, you’re wearing the white coat over your black dunce cap. Good luck going back to being a telemarketer.
If you don’t have the ability to be honest with yourself and your patients you are FAILING (um, dude… you’re overweight and you ain’t NEVER gonna’ feel better until you get off your ass, turn of the TV and in the name of all that is holy, step AWAY from those tasty morsels of chip heaven). And while that’s the message, you need to present it in a way that the patient can receive.
What’s the risk?
You tell someone they are personally liable for their own health issues and what? They don’t like you? Blame you for holding them responsible?
My conscience is clear and I will sleep like a princess.
Day after day I see patients who have been to doc after doc who have promised to help them, and then one of their good friends says, “hey, you should go see my guy.” And then they sit there in that chair across the room from me, vomiting the exact same sob story of how this and that “happened to them”, resulting in this condition that all of they who came before FAILED to remedy.
I wear a black lab coat. Inside, and out. I tell my patients the truth, and the truth hurts like a staple through the nail of your big toe… BAD. They don’t always like it, and some of them leave. But the key to being a medical practitioner and not a snakeoil salesman is to provide the support you can.
Am I able to stop fatty-Mc-fat-fat’s feet from hurting? Maybe a little. Can I strip away 134 pounds of excess “I hate myself”?… not overnight, that’s for sure. Hell, maybe not even this year. But I can help his body start to use food more efficiently. I can boost his energy level enough to support him getting off the couch. I can work WITH him through a twelve month health plan including diet and exercise to get him back on his feet.
But only if I start out by being honest.
My black lab coat doesn’t give me license to be mean, or hurtful… I still have to present my thoughts and findings in a sensitive manner; one in which the patient can not just hear me, but also sign on as a partner in what has to happen. My black lab coat allows me to be blatantly honest with patients, many of whom have been lied to.
Originally created for ericsays.com: September 15, 2011