By: Kara Frame, MD
I am a mother. A wife. A daughter. A sister. A friend. I am a doctor. I am a runner. Just like everyone, there are many pieces to my core identity. These are the traits that encompass the fixed view I hold of myself. These ring true for me, even when (at times) reality paints a different picture.
I just went for my first run in over 3 months. Viewed from the outside, this does not really fall in line with the way I just described myself (i.e. a runner) but, to me, this fact does not get in the way of my claim. Running is something that I have been doing for my entire adult life and much of my childhood before that. Over time, my involvement in this practice has waxed and waned all the way from training for marathons down to my current minuscule level. However, my commitment to running has never diminished.
As a family doctor, my primary focus is on my patients’ well-being. Often, this means managing chronic diseases or advising on prevention. I frequently counsel patients on ways they can optimize their health…quit smoking, increase exercise, cut back on so much red meat and cheese, etc. What may seem like straightforward advice is often met with blank stares and resistance. Even after providing the unwelcome news that “you have high blood pressure,” or “you have diabetes,” patients might seem unwilling to make even small changes. Why?
One of the great gifts of this profession is that people not only entrust me with their health, but they also entrust me with their lives. I hear details of their stories that close family or friends may not know. It is humbling. This is a privilege I do not take lightly. The open communication can strengthen the doctor-patient relationship, bringing not only connection but also understanding. Why won’t my patients heed my advice? Commonly, the answer is because I am challenging a core identity. When met with blank stares or “I can’t do that,” instead of charging unwaveringly ahead with the plan I have for them, I have the ability to pause, ask for more details, and acknowledge, with empathy, this internal conflict I have created. By considering the patient as an individual rather than a list of values and conditions, I open the door to not only learn a little more about another human but to also adapt the recommendations and plan something achievable. When we point out, gently, the discrepancy between people’s behaviors/actions and their self-image, it can be a powerful motivator for change. We can empower them by validating their perception and leveraging this for their success.
I am a runner who has run once in 3 months; I guess I better go put on my shoes.
Kara Frame, MD, is an Assistant Professor (Clinical) in the Division of Family Medicine which is housed in the Department of Family and Preventive Medicine at the University of Utah. Her academic interests include resident education, behavioral health, and clinic quality improvement.