Jul 21, 2026 · 58 min · 10 segments
Most of us who care for patients can remember seeing a name on the schedule and feeling our heart sink. What makes some clinical relationships so difficult? Is it something about the patient—or…
And I'll mention a couple of the items where it sounds like if people... agree with this.
And I just want you to comment on a few of these that tends to suggest the doctor is going to generally have more difficulty.
If they say exploring psychological issues with the patient often causes me pain.
That was one of the ones which sort of seemed to align with the doctor who would have more difficult encounters.
Yeah, well, I mean, the Ashworth scale or the doctor's belief scale is pretty old.
And so that's where most doctors are mostly practicing, you know, the Marcus Welby type of approach.
So, yeah, I think that most doctors that are going into primary care either get out or don't go into primary care at all if they're not at least somewhat biopsychosocially oriented because, you know, we're not mechanics.
In addition to love or whatever that field is, there's a component of it's something I can fix.
So I'm going to offer you a quote from a doctor who was actually working in a hospital and ask you how we could help this kind of doctor.
The doctor says, sometimes we have to limit our empathy in order to preserve our own energy and ability to care for patients every day.
Because if you fully, 100% empathize with every single patient, you would be just so burnt out.
First of all, does that sound right to you? I mean, can I say it to myself each morning?
Well, I mean, you know, I'm constantly having to remind my residents that the patient is the one with the disease.
And I'll mention a couple of the items where it sounds like if people... agree with this.
And I just want you to comment on a few of these that tends to suggest the doctor is going to generally have more difficulty.
If they say exploring psychological issues with the patient often causes me pain.
That was one of the ones which sort of seemed to align with the doctor who would have more difficult encounters.
Yeah, well, I mean, the Ashworth scale or the doctor's belief scale is pretty old.
And so that's where most doctors are mostly practicing, you know, the Marcus Welby type of approach.
So, yeah, I think that most doctors that are going into primary care either get out or don't go into primary care at all if they're not at least somewhat biopsychosocially oriented because, you know, we're not mechanics.
In addition to love or whatever that field is, there's a component of it's something I can fix.
So I'm going to offer you a quote from a doctor who was actually working in a hospital and ask you how we could help this kind of doctor.
The doctor says, sometimes we have to limit our empathy in order to preserve our own energy and ability to care for patients every day.
Because if you fully, 100% empathize with every single patient, you would be just so burnt out.
First of all, does that sound right to you? I mean, can I say it to myself each morning?
Well, I mean, you know, I'm constantly having to remind my residents that the patient is the one with the disease.
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