Physicians Need to “Know” Their Patients to Provide Quality Treatment

If you’re in a car accident, a construction accident, or any type of accident, you may treat with surgeons, orthopedists, pain management doctors, and other specialists. If you’re lucky, you have a caring family doctor who helps to coordinate and oversees all your medical care with these most medical specialists. In most accident cases, your physicians know little about you except for the specific part of your body they’re treating.

Novelist Robertson Davies wrote in The Cunning Man that doctors need to get to really know their patients – even if it means sniffing their body and questioning their soul. A new report in the Washington Post takes Robertson’s novel to heart. The author suggests that doctors need to do “‘biopsychosocial’ biopsies, where they learn who their patients are as people.” The author of the Post report is Michael W. Kahn, an assistant professor of psychiatry at Harvard Medical School and on the staff of Beth Israel Deaconess Medical Center.

Kahn begins his point of view by giving a common example of how doctors need to understand their patients better. A college student was admitted to the Medical Center’s psychiatric unit after her boyfriend had “dumped her by text and then ghosted her. She got tipsy, swallowed a handful of pills, and sent several ‘goodbye’ messages on social media.” Her friends dialed 911 and the campus police brought her to the medical center. A psychiatry resident who Kahn was monitoring gave Kahn the student’s symptoms, medical history, results of a physical examination, and lab test results – standard medical practice for psychiatric care.

Kahn then asked the resident what should have been a straightforward question – what caused the breakup? The resident didn’t ask the patient because the resident thought that was too personal a question.

Kahn emphasized this is a common “medical paradox.” Doctors are quick to enter a patient’s body but hesitate to enter their mind and soul. Doctors conduct all sorts of physically invasive tests including checking prostate glands and uteruses – and asking questions about genital or bowel problems. For some reason, doctors hesitate to ask personal questions – even though for many patients, not just the ones in psychiatric care, the personal is what makes them comfortable. Just as many legal clients want their lawyers to understand who they are, Kahn states that patients are generally more comfortable when they think their doctor understands them.

What is a “biopsychological biopsy?”

Kahan recommends a medical procedure/test, a biopsychological biopsy, which “collects samples of the patient’s biographical, psychological and social worlds.” His idea is set forth in more scientific detail in a recent article in the American Journal of Medicine.  The procedure focuses on a skill medical students are already taught – “tell me more about” about what’s bothering you – and then explore the answers in a scientific methodical way.

Kahn suggests that physicians ask their patients four questions:

1. Where and with whom do you live?
2. How do you spend your days?
3. Who are the important people in your life?
4. What sorts of things give you pleasure?

The biopsychosocial biopsy should be viewed as the opening moves of a chess game. It starts a discussion. Depending on the answers, the physicians may follow up or proceed in different directions. Kahn suggests that the biopsychosocial biopsy should be viewed as a personal conversation that works better when both doctor and patient are seated.

How a biopsychosocial biopsy could help with your injury claim

When you have suffered an injury because of a car accident or a fall, your doctors are likely focused on what hurts, what’s “broken,” and what can be fixed. All of these immediate, physical needs are important, but they are not the only needs a victim has. Mental trauma and anguish can last for a long time after an accident.

For example, a 1999 study published in American Family Physician found that car accidents were the leading cause of post-traumatic stress disorder outside of active combat, stating that 9% of all accident victims developed PTSD. In 2018, researchers put that number at 22.25%, claiming the “prevalence of PTSD among RTA [road traffic accident] survivors found in this study significantly underscores the need for providing timely and effective intervention strategies for RTA survivors.”

What this means is that long after broken bones have healed, about one out of every five vehicle crash victims is still dealing with the effects of that crash psychologically. Severe cases may leave a victim unable to drive at all, which can make it impossible to work or engage fully with your family. Some victims may develop a fear of going outside altogether, though that type of extreme reaction is rare, and usually takes time to develop.

A biopsychosocial biopsy can help create a baseline for what your life was like before the accident, and how it has changed since the accident. This can help bolster your claim about the long-term effects of a car accident even after your injuries have either healed, or reached the maximum medical improvement.

At Philbrook Law, our Vancouver, WA personal injury lawyers work with your primary care doctor, specialists, psychiatrists, and psychologists. Victims are entitled to compensation for their physical pain, and also their emotional suffering. To discuss all aspects of your injury case, please call our offices in Vancouver or Battle Ground, WA. You can reach us at 360-746-0351 or use our contact form to schedule an appointment. We represent personal injury clients on a contingency fee basis.