This post is the third and final of this year’s series on medical lessons learned from movies. It relays the story of Dr. Jack McKee, as told in the 1991 film "The Doctor," starring William Hurt. The movie is loosely based on the 1988 book, "A Taste Of My Own Medicine," an autobiography by Dr. Edward Rosenbaum.
What do you call a doctor whose attitude and approach toward patient experience transform entirely within just a few months? One who gets a taste of his own medicine.
That's the story of Dr. Jack McKee, a successful surgeon at a leading San Francisco hospital. His bedside manner is severely lacking. As a surgeon, he expresses his care with a scalpel.
"Surgery is about judgment ... you have to be detached," he remarks to a group of interns during rounds, early in the film. "Caring is all about time. When you've got 30 seconds before someone bleeds out, I'd rather you cut straight and care less." In addressing patients, he comes off as arrogant, aloof, and, at times, inappropriately and cynically flippant.
In one scene, when a female patient with a chest scar mentions that her husband wants to know if it will go away, he responds by saying that she should tell him she is just like a "Playboy centerfold because she has the staple marks to prove it." In another, he says to a patient who had attempted suicide, “Want my advice Robert? The next time you want to give yourself some real punishment, try golf. There is no greater torture.”
Not long into the movie, Dr. McKee starts having medical challenges of his own. After having a coughing fit and spitting up blood, he is referred to an ENT specialist, Dr. Leslie Abbott, whose cold, impersonal bedside manner is just as offputting as his own.
"I am the doctor and you are my patient, and I’m telling you when I am available," she says at one point to demarcate her authority. (Later in the film, Dr. McKee confronts Dr. Abbott, calls her out on her cold, callous behavior, and ends their doctor-patient relationship.)
Following a biopsy, he learns he has laryngeal cancer and is treated with a course of radiation. That diagnosis (and subsequent surgery) serves as the beginning of his transformation from doctor to patient, where he experiences life on the other side of the chart. He is confronted with healthcare system red tape and the emotional vacuum hospitals, some doctors, and other medical personnel exhibit—contrasted dramatically by the empathy he sees patients showing one another.
June Ellis, a patient with an inoperable brain tumor, has a particularly profound effect. Her character serves as a catalyst in his metamorphosis from uncaring physician to compassionate human. The two befriend one another. Her illness and willingness to share hard truths, coupled with grace and vulnerability, impacts him greatly. In the end, Dr. McKee's cancer is treated and cured, but June succumbs to her illness. He is forever changed.
As the film progresses and his attitude shifts, Dr. McKee teaches interns the importance of showing compassion and sensitivity towards their patients.
During rounds, he barks at one intern sternly, "If I ever hear you describe another patient as 'terminal' again, that's how you'll describe your career!" Later on, he says to the group, "You've spent a lot of time learning the Latin names for the diseases your patients might have. Now it's time to learn something simpler about them; patients have their own names." He then has the interns dress in patient gowns, assigns them various illnesses, and orders lab tests so they can experience what they will soon put their patients through.
What 'The Doctor' Teaches About Patient Experience
The importance of positive patient experiences is at the forefront of medicine, especially during the current crisis. Though healthcare was very different in 1991 when the film was released, it still serves to teach us several valuable lessons about patient experience and patient satisfaction.
Just before Dr. McKee's surgery, his surgeon, Dr. Eli Blumfield (a man he had ridiculed for being too caring), said, "I'm going to keep telling you everything I'm doing as I'm doing it."
Continuous communication with patients and their families is one sure way to improve patient satisfaction.
A touching scene that clearly demonstrates Dr. McKee's transformation follows a successful heart transplant surgery. He leans over to the patient, who is still under anesthesia, caresses his head, and whispers, "It's a beautiful heart."
We talk a lot about the need to express empathy on this blog, for a good reason: What you communicate to the patient and their family is one thing—how you do it is another. Express empathy in the way you speak, ask for feedback, and listen to the patient and the caretaker/loved one with minimal interruption.
Allow Patients to Impact You
As a doctor, you may feel the need to keep your professional distance, to maintain a sense of objectivity. However, just as June impacted Dr. McKee personally and professionally, consider letting down your guard to allow patients and their experiences to affect you.
Two deeply personal stories shared by SCP physician leaders, Drs. Randy Pilgrim and Ken Henrich, embody this tenet. Not unlike Dr. McKee, they had patient encounters that forever changed their perspective on patient care.
Commenting on his experiences, Dr. Pilgrim said, "Most of us will see many thousands of patients in our careers. Some encounters are routine. Some are dramatic. ... Examples abound. We do impact patient's lives and often change them. Interestingly, the opposite happens, as well. Patients can change us. ... We want to make a difference in patient's lives. And if we let them, patients can make a difference in ours as well."
Sharing his story, Dr. Heinrich said, "The ability to empathize with patients and families is crucial in establishing the patient-doctor bond that is such an important component of the treatment process. In a field where we have only a few moments with our patients, this becomes even more relevant. ... [W]e should always search for some common ground and try to understand what our patients must be feeling."
(Read their full accounts here: The Patient Who Changed Me and Inspirational Patient Encounters–First-Hand Account)
The Doctor covers a range of topics: the failure of the healthcare system to prioritize patient experience over policy, physician insensitivity, interpersonal relationships, and legal and ethical issues.
But the film's core message is that patients should be the central focus of our attention, not because it will improve HCAHPS scores or enhance a particular doctor's or hospital's reputation, but because it's the right thing to do.
The movie also has many poignant moments. One, in particular, takes place during Dr. McKee's confrontation with Dr. Abbott. He says, "Every doctor becomes a patient somewhere down the line."
Whether or not we find ourselves in a similar situation as Dr. McKee, we should always be mindful of that—and of something the well-known philosopher Plato said: "Be kind, for everyone you meet is fighting a hard battle." Not some people. Everyone. It begs the questions: What heavy load might our patients be carrying? To whom can we show kindness, compassion, and empathy today?
Most doctors, nurses, technicians, and therapists entered their professions with one main goal: Heal the sick. Sometimes, that requires a surgeon's scalpel, and at other times, a kind word gently spoken.
Service, dignity, and respect for our patients are hallmarks of the SCP Health culture. Learn more about our culture and opportunities to work with an organization that puts patients' (and providers’) needs first.