Medical students learn to establish a patient’s trust. But how often does this really happen?


This column is the opinion of Leah Sarah Peer, a medical student in Montreal. For more information on CBC Opinion Sectionplease consult the FAQs.

Navigating the healthcare system was nothing new to me. But waiting more than 14 hours with my sister before seeing an emergency doctor who refused to listen to me was.

When he walked in abruptly, he glanced at a resident doctor’s notes, observed my sister’s scalp, and found the location of the pain that kept her awake at night.

He placed his fingers on the area and pressed to assess the presence of pus or infection. I saw her wince in pain, but I also saw that she didn’t trust the doctor enough to say anything.

I was furious. This doctor’s approach did not match the bedside clinical skills I was learning in medical school. We were told the importance of giving our full attention to the patient, to make sure we didn’t miss any signs and symptoms for a potential diagnosis.

As a future doctor, I know it is my duty to be an advocate for patients and to support them, even if I don’t immediately know how to treat them. I am committed to seeing my patients as people, not just diagnoses.

But in that triage room in Montreal last fall, it felt like wasting a doctor’s time.

When I tried to open up the conversation, articulate possibilities, and understand the doctor’s style of thinking and reasoning, I was ignored. My sister was sent home and told to come back to the ER if her symptoms changed.

The system we both trusted failed my sister. What she considered a serious problem was dismissed as nothing.

Perhaps more opportunities for patients to share their stories and research focused on the lived experience of patients will contribute to meaningful change and improvement in the clinical relationship. But physicians must also be open to a collaborative model of care by listening to the patient in front of them and trusting that they are the experts on their own bodies.

This collaborative model includes working with other members of the healthcare team, so specialists can come together to better discuss a patient’s case.

As the delivery of health care becomes more complex, due to the implementation of new technologies and increasingly specialized doctors who are dependent on each other, doctors will have to adapt.

Leah Sarah Peer is seen at a British Red Cross health fair on the island of Anguilla in January 2020. (Submitted by Leah Sarah Peer)

This adaptation must also include creating safe, inclusive, anti-oppressive and anti-racist spaces for health to facilitate dialogue, trust and connection. This will improve outcomes, safety and quality of care for diverse patient populations.

I now realize that every interaction with a patient has an impact on their decisions and their relationship with the healthcare system. I see it in the fear my sister has now when she goes to the hospital. Medicine is a lifelong learning profession; this process does not stop once you have your medical degree. It is a journey of discovery that I will undertake with each patient, combining compassion and science, to serve them.

If health spaces are unsafe and instead exacerbate harm due to systemic racism in health care, a lack of inclusive care, or a lack of knowledge about care for people of color, there is there is a lot of work that needs to be done. And if a doctor’s behavior is the result of burnout or stress from staff shortages, shouldn’t we address it immediately?

There is no excuse for inadequate care or dismissal, misdiagnosis and potentially life-threatening consequences it may be the result of disinterested and biased doctors.

In an overburdened healthcare system like ours, showing compassion and listening to the patient in front of you can still go a long way.

My sister’s experience is one that is far too common. It’s time we did better. Quality healthcare begins the moment a patient walks into a clinic or hospital, as it is truly at the heart of medicine.


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