It’s a seductive idea. We doctors possess knowledge and experience which can not only help people, but can save their lives. We get opportunities to be the right person at the right time to offer the right help that makes all of the difference. It’s one of the greatest things about our profession. It’s also one of its greatest traps.
I’ve heard many doctors refer to themselves as “healers,” as if we have some special power to bring about healing in our patients. This idea confers some sort of a higher status and originates, to some, from a “higher calling” to a more noble life. Again, this is a logical step, in that we have opportunities on a regular basis to help and even save the lives of people. It’s natural to believe that somehow the healing power comes from our touch, or even from our knowledge.
It doesn’t. I am not a healer.
Healing is what the patient does, not the doctor. As a physician, I am certainly one who can help the patient find a faster road to healing, but I don’t heal. I help.
Why am I taking the time to talk about this? Why get stressed out over whether I am a helper or a healer? I think that the belief in doctors as healers causes significant harm to both doctors and patients, and that getting a better perspective about the roles of each will greatly improve the care given. Here’s why I believe this is a topic that needs addressing:
1. Doctors Often Fail at Healing (And Will Always Ultimately Fail)
There are many patient problems that do not get better, despite my best efforts. There are countless pains I can’t remove, and many problems I do not solve. Even when I succeed, the success is always temporary, as a new problem will eventually come back. And if healing is our ultimate goal as physicians, we all are total failures, as all of our patients eventually die. If healing is held as our goal, we fight a losing battle. We are the soldiers in the Alamo, offering impotent resistance to an overwhelming force.
If I believe in myself as a healer, I will face constant disappointment and defeat.
2. When Healing Occurs It Is Often Independent of Doctors
My patient may follow my advice and not get better, or may disregard what I say and recover from their problem. My direction is imprecise and imperfect, based on my knowledge and experience along with what I believe to be happening with the patient. But my experience and knowledge may not be right, and my interpretation of what is happening with the patient may be inaccurate. Healing is something that happens in the patient’s body. It’s when they get better, whether or not I am involved in the process.
Belief in myself as a healer is based on a falsely high opinion of my knowledge and abilities.
3.Patients Who See Doctors As Healers Expect too Much
I’ve seen it. I’ve heard people’s frustration when I’ve told them I can’t fix their problem or remove their pain. They feel like they shouldn’t have to hurt, or that if there is something wrong it’s because I’ve missed something. These are the folks who buy the “miracle” cures pandered by Dr. Oz and other profiteers. They hear the promises of health and wellness from the media and are disappointed when we can’t offer the same.
By believing I am a healer, my patients will eventually be frustrated and disappointed.
4. Doctors Who Try to Be Healers Harm Their Patients
The pressure to find the “magic bullet,” or the unifying diagnosis leads many doctors to practice bad medicine. This is a pressure we all feel when faced with the powerless feeling some patients bring. This leads to the ordering of unnecessary tests, performing of unnecessary procedures, and prescription of medications that should not be given. I believe this is what drives many doctors to overly-prescribe narcotic pain medications and other addictive drugs. We don’t want to stand helpless; we want to do something.
To protect my role as a healer, I am drawn away from my training and toward the task of finding a miracle. In doing this I can cause significant harm.
5. To Protect Their Status As Healers Doctors Will Challenge Any Other Perceived Competition
Doctors in the past have been held with reverence by the general public. We possessed that “secret knowledge” that others didn’t have access to, knowledge that fueled our healing power. Now everyone has access not only to all of the knowledge we have, but also to others who offer alternatives. This causes many doctors to aggressively discourage patients to research their own problems and to attack alternative providers. In defending their turf, however, they are giving patients an ultimatum: us or them. More and more patients are choosing “them” because of this and are rejecting what we offer.
By clinging to our power as healers, doctors have greatly harmed people’s trust in our profession.
So what’s the alternative? Does it really make a difference what we call ourselves as long as we practice medicine? I think it does. Now that I’ve got time to choose the best way to practice, I’ve seen that there is a much better alternative to being a healer: being a helper.
Yeah, that sounds all dull and boring, I know, but it is not only more realistic, it is a much better way to practice medicine. Here’s why:
1. BY BEING A HELPER, I ALWAYS CAN SUCCEED
I may not be able to fix someone’s pain, but I can reduce it or can help them get through it. Every visit is an opportunity to help someone, and once I have helped them I’ve done something that can’t be taken away. I don’t have to see disease as a foe to be defeated, but as an opportunity to give to my patient from my experience and knowledge. Even when patients ultimately succumb to death, I have many opportunities to help them do so with peace.
2. BEING A HELPER KEEPS MY PRIORITIES STRAIGHT
I don’t have some crazy idea that I have special powers. I don’t believe that I’ve been “called” or “chosen” to do magic. I just help people. My focus isn’t on me (as if my care was not a performance), but on the person I am helping.
3. BEING A HELPER KEEPS EXPECTATIONS REALISTIC
If my patients see me as a helper, not a healer, they will listen to my advice with different ears. I am standing beside them, not above them. They are far more likely to listen to me when I am offering help, not pronouncing my wisdom.
4. HELPING MEANS DOING NO HARM
The temptation to offer more tests, more procedures, or dangerous drugs becomes much smaller when I take the role of helper over that of healer. I don’t see a need to prove myself, and will consider the harm of actions much more closely. I won’t over-prescribe pain medications because I will see how it harms my patients in the end.
5. BEING A HELPER LETS ME EXIST IN THE INFORMATION AGE
Like it or not, I am compared to the homeopaths, the herbalists, the chiropractors, and the doctors on TV. When people embrace alternatives to the care I give, they are not necessarily rejecting me; they are seeking what they are when they come to me: to feel better and to lessen their fears about the future. If the help I offer is held next to the miracles promised by others, I think I will win. If patients are helped by others, though, then I should be glad for my patients, not upset about the success of my “rivals.”
We call what we do “health care,” which implies a relationship built for the sake of a person’s health. I believe the best way to accomplish this is to have a realistic view of who we are and what we do. I am not a healer. When I try to be one, I always fail and am always disappointed. I am a helper, and in taking that role I can always have opportunities to succeed.
Questions for you:
If an eye doctor prescribes glasses rather than help people improve their eyesight (without surgery or some permanent prop), is s/he a healer? [I don’t think so.]
If a family doctor repeatedly prescribes antibiotics because of a returning bladder infection, is s/he a healer? [I don’t think so.]
Is a someone who prescribes medicine in case of high cholesterol a healer? You guessed it: Not until better diet and exercise options have been exhausted. In most cases oatmeal will do.
True healers find the cause and remove it. True healers restore natural health whenever possible. Anyone who prefers pills is not a healer.
I got rid of high cholesterol, glasses, back pain, bladder infections, and skin rashes without doctors. I still have medicine for thyroid. Working on it.
That’s true. absolutly agree
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Patients definitely have to take an active role in their “healing”. That also means the patient has to do their homework and not just accept any type of treatment. Options should be explored, in both traditional medicine as well as alternative or holistic practices if desired.
Good doctor patient communication is also important as many times patients don’t voice their questions or concerns before treatment.
Also patients need to take a deeper look into what their health insurance coverage plan offers in regards to treatment options. Many people get insured but aren’t fully aware of the details of their policy.
Absolutely agree. Too often this evokes a form of laziness in the patient, even a dissociation from the condition. So much of that healing process needs to be facilitated by the patient themselves and simply directed by us.
Rob, I started my book, “Demanding Medical Excellence,” with an old saying: God heals, and the physician sends the bill.
The maximum wellness that all the best genes in combination with the most favorable environment ..all these together now in 2014… Call this health v. 1.0.
Don’t you think that we are learning enough so that we can improve on this?….so that we can exceed the best baseline that nature and nurture can offer? Call this health v. 2.0.
With 2.0 we live 120 years, our joints and back feel great. Our energy allows us to ski until we are a hundred. Our IQs are high. Sex is great. We remain productive and our interests remain acute. and death is almost optional.
Dreaming fiction may help us invent a new reality.
This is a super post on so many levels, thank you.
First, we are talking about the sick care system-it has nothing to do with health; if I was healthy I would not go to the doctor. Duh…..
When a doctor is seen as a healer, it seems almost like the give me a pill mentality. As if a pill will offset poor diet, stress, too many bad susbstances and on and on. Reality is the larger system is driving ill health, visible by the number of overweight (look at old pictures and how slim and lean people were, we look like a new species, Americanus Waddlus) people and the accompanying conditions resulting from the underlying metabolic condition. The sick care system could certainly be more efficient, but let’s not kid ourselves. The solution lies in the arena of public policy. In a country where one of the major political parties denies the science of climate change and pizza is a vegetable on school lunch menus I am not optimistic.
It does seem a little egotistical on the face of it to consider ourselves “healers”. After all the body has the capacity to heal itself. However, I do believe many physicians posess a knack for either personal interaction and intuitive skills or mechanical /intuitive skill in performing procedures or surgeries that can be honed, but not necessarily learned. In that regard, there is some similarity to the Shaman, or healer of old.
Facilitator, I think is an even better description than healer or helper. But I agree with lawyerdoctor, we’d like to think of it as a little higher calling after all the training and time we put in.
Remember also that doctor is derived from the word “to teach”.
That reeks of sexism unless men have catalytic converters too.
I’m looking and I don’t find one. Oh wait…what is this?
Sometimes we heal, fix, cure and sometimes we help, assist, tune up, make better. Aren’t we, accordingly, akin to auto mechanics? Perhaps what-we-are is best left to our patients to proclaim and we should only claim to know a little human biology? … also akin to the generic claim of auto “mechanic”. Medical doctor thus seems fine to me. As Hillary would say “what difference does it make?”
I think Hillary needs to have her catalytic converter cleaned out.
Why not just meditsinskaya robotnik?
Helper is too broad a term.
How about healthcare information and technology application specialist?
Gee, I’m really glad now that I spent all that time, energy, and money going to “helper school” . . .
LOL. “How may I help you today?”
I really wasn’t trying to be snippy (ok, maybe a little).
I enjoyed Dr. Lamberts’ article – but I do think doctors are “more than helpers” if not slightly “less than healers.” I know we are not God and I don’t try to play one on TV. But I do think there are components of what I do that are more than just being a social worker or traffic director. I wear my white coat. I try to be honest and sometimes humorous with my patients but I’m still the guy who is the “Shaman” – they have to believe I can “cure” them before I can “help” them.
A doc I knew once that did a long, complex renal resection on a patient for cancer. He finished and spoke to the family afterwards in the OR waiting area. The wife keep wringing her hands and exclaiming over and over, “Thank you Jesus, thank you Jesus for saving my husband!!”
Finally, the doc pointedly explained: “Ma’am, your husband is going to be fine, but Jesus didn’t DO the operation, I DID.”
I agree that we are “more than helpers if not slightly less than healers.” I am not thrilled to be a helper either. The point of this was to simply point out that we are no higher on the scale of humanity that those we treat. Unfortunately we physicians often want more credit than we deserve, leading to the defensiveness and excuse-making you hear from docs when their cover is blown. I guess I just feel it’s better to under-sell ourselves than to overdo it. We are neither priests, prophets, nor miracle-workers. We do best when we listen carefully and treat our patients with respect and patience. It is a high calling, but the calling doesn’t make us better than the people we treat.
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I totally agree. That Doctors are great helpers but the patient plays the biggest role in their healing. I think so much of what patients experience if they only knew more they would make better choices. I recently had a patient who I had to take home from having a stroke. I noticed that the patient when we got home is wife gave him soda, cookies by the bed side and unhealthy meatloaf and he is very overweight. It is shame that many people simply do not know better.
We both agree about being helpers. My point about the role of the physician being larger than the person is illustrated by Eric Cassell in one of his books. An asthmatic doctor got all the correct advice and prescriptions by curbsiding a specialist but did not get better. He switched doctors and got the same basic prescriptions from a doctor who showed that he assumed the responsibility of treating physician. The asthmatic doctor’s symptoms cleared.
I agree that we are only helpers when it comes to fighting disease. But there is more to being a doctor than that. Even though you don’t say it, I suspect you are a healing presence to your patients. Healing applies to the person with the illness, if not to the illness itself. By your engagement, with your knowledge and through your acquired wisdom you probably often fill your patients’ archetypal need for a physician who can mitigate their suffering, if not conquer their illness. I agree we should be humble about our abilities, but we must also be fearless in supporting our patients in their personal struggles with their disease and the mortality we must all face. Sometimes our role is bigger than we are as individuals. We can and must rise to that challenge without hubris or false promises.
I wrote this because I see a lot of my own personal pitfalls, as well as the failings I see in other doctors, coming more from where I overestimate my own value than when I underestimate it. We are normal people given a task to help other people. The nobility of the task does not confer nobility to the person doing it, but the way in which the task is done can confer nobility.
The bottom line, though, is that health care is not about us as physicians; it is about our patients. We need to get over this desire for special status and start simply trying to help our patients. Besides, what’s so bad about being a helper? Isn’t that noble enough?