How Otolaryngologists Can Navigate the Physician–Patient Relationship with Performing Artists

As we understand potentially influential factors in the development of the performer, we must also examine healthcare providers and some of the predilections we bring to the table.

Personality Traits of Physicians
Although the process continues to evolve, the training of medical students and residents can involve and even promote maladaptive behaviors (Physician Exec. 2013;39:14–16,18,20; CMAJ. 2012;184:1980; Acad Med. 1999;74:1327–1333):

1. Competitiveness: this can begin in primary school with a focus on test scores and grades.
2. Type A Behavior: Briggs-Meyer evaluation confirms this.
3. Social Isolation: Physicians continue to work on work–life balance and how the commitments to work overshadow social interactions.
4. Identity with Vocation: The commitment to work can overshadow our humanity.
5. Safety Seeking and PTSD Symptomatology: Risk aversion is present, but can negatively influence decision making.
6. Emotional Dissociation: Consider cadaver dissection as the introduction in most medical schools.

The Makings of a Perfect Storm

In the quest to understand our imperfect humanity, we have to consider how a physician who feels socially isolated might be tempted by adjacent fame. The mystique of a talented artist could become a stumbling block for a physician who is not mindful of the professional codes that protect the physician–patient relationship.

While provisions such as seeing patients during off hours to avoid waiting room chaos are reasonable, the forces acting on these encounters can be formidable and must always be recognized and respected. The role of managers, producers, agents and directors should also be recognized, though their respective roles should never eclipse the centrality of the patient’s well being.

Checkpoints

1. Is what I’m doing part of accepted medical practice? Define your boundaries and communicate them and keep them.
2. Is a deviation from standard truly unavoidable? Be honest with yourself. Find your core principles.
3. Is what I’m doing solely in the interest of the patient? Develop a clear mind of discernment.
4. Is what I’m doing causing me stress, worry, or guilt? Listen to that voice of caution.
5. Have I sought the counsel of a friend or colleague? Identify a professional mentor/confidant and build your support network.
6. If someone publicized this event, would I be comfortable explaining my choices and actions?

Dr. Sims is an associate professor of otolaryngology at the University of Illinois in Chicago.