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"It's Your Medical Team... May We Enter?"

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"It's Your Medical Team... May We Enter?"

Sep 17, 2020

The subjective education taught in medical school can cause medical professionals to presume patients will inherently give their trust, thus allowing us to move freely in their space and examine them without questioning. In this mentor moment, Margaux recalls an informal, but important, lesson learned while performing patient care.

Episode Transcript

There are many things that we are formally taught in medical school about patient care, like how to do a physical exam, how to round and present patients, call consults, and other things. But I didn't realize how much this objective education had dehumanized patient care until I worked with Dr. Raman on the pulmonology service as a medical student.

Halfway through my third year I was starting internal medicine rotation on pulmonology. I nearly ran into Dr. Raman as he unexpectedly stopped before entering a patient's room, who, approaching the first patient's door, knocked, poked his head in and said, "Hi, it's Dr. Raman with the pulmonology team. May we enter?" And the patient allowed us to come in.

During that moment, I realized how little privacy, autonomy, and space we give our patients when they come to stay at a hospital. I realized how I may have violated so many other patients' privacy up until this moment, and how we take for granted the spaces that we enter and have privilege to use as medical professionals.

In a way, we're socialized in medical school to assume patients will inherently trust us, thus allowing us to move freely in their space and examine them without question. But there are so many reasons for patients to not trust us, like generational and historical trauma, racism, language differences.

This moment was important to me because intentionally respecting patients' space by knocking, and asking, and waiting to be invited in while they are in a vulnerable situation provides me with a moment to connect on a humanistic level. It allows for more equitable conversation about that individual's health.

Why that moment mattered was realizing that even though a patient is in a hospital, even though we are there to treat them, they still have their own autonomy and respect and need space. We need to be reminded to treat them like humans, and the simple act of asking them if we can enter their room sets the precedent of treating every patient like a human.

The rest of that week, working with Dr. Raman, he continued to knock on every patient's door and respect every patient's privacy. There was only a couple patients that said, "Can you come back in a little bit?" to which he respected.

Dr. Raman modeled humanistic care without overtly teaching us. By the end of the rotation, the resident and I were in the habit of asking permission to enter rooms. Dr. Raman did not formally mentor me in the way I traditionally think about mentorship, but actions speak louder than words. Even simple things like asking to enter a room makes a huge difference in patient care.