The power of ‘doing nothing’ in medicine

Medicine is more often about comfort and reassurance than about diagnostics, big machines and glass-fronted hospitals.

 In medicine, most patients present with anxiety because the fear of illness is far greater than the risk of illness. These unfounded fears are whipped up by a thoughtless public awareness campaign, a celebrity ‘illness’ splash to aid a fading career, insensitive comments from a relative, or ‘Googled’ minor symptoms that always suggest: “Consult your doctor, you may have cancer.”

So every patient has an agenda, often hidden for fear of seeming foolish. But with experience, respect, and humour, these unfounded anxieties of cancer, heart disease or the weird and wonderful world of Internet misdiagnoses spill forth. This is the opportunity to reassure and take away the fear; “You will be okay” is the only phrase anyone ever wants to hear.

Even in terminal situations, our role is to reassure, tell everyone that they are doing well.

Regrettably, at undergraduate and postgraduate levels, every medical text spectacularly fails to understand this.

We do not select doctors on their ability to effectively reassure and communicate. Concerns and patients’ agendas are missed and the opportunity to reassure is lost.

An uncertain doctor suggests investigation under the pretext of reassuring the patient, but in fact this is only to reassure themselves.

So a patient who previously felt foolish now feels that there ‘must’ be something wrong.

Of course, investigations lead to spurious results, referrals and endless anxiety about health — a system clogged with now fearful patients and dissatisfied doctors.

Remember that often, many doctors are uncomfortable with the idea of not doing anything.

Reassurance should be the main part of managing certain concerns.