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    5 principles

    New book holds five humanities to heal by

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    Liz Crocker
    At a time when it's fashionable to call the "doctor-patient" relationship a "doctor-consumer" relationship, cosmetic surgeons have to stop and think about the human side of their interactions with patients, claims Liz Crocker, coauthor of Privileged Presence: Personal Stories of Connections in Health Care . The bond stemming from such interactions does not have to do with surgical skill or impressive technology; rather, it results from showing patients respect, a spirit of collaboration, empathy, a willingness to communicate and kindness.

    Ms. Crocker tells Cosmetic Surgery Times that she and coauthor Bev Johnson, a registered nurse, wrote the book to showcase real-life points of view and experiences in health care. The authors offer key elements that make for good connections between doctors and their patients.

    THE HEALING VIBE "This is not frivolous but actually makes a difference when there is a good connection in health care — not only in terms of how the health care professional feels about the relationship, but also in better outcomes, better pateint compliance with post care, and better appreciation of the mutual relationship," Ms. Crocker says.

    One of the book's vignettes has to do with a woman's experience with a plastic surgeon. The woman, in her 20s, was rushed to emergency surgery because of a hepatic adenoma. The benign tumor exploded inside her body and blew apart her liver and gallbladder. The surgery to resect her liver took more than 15 hours due to her intense bleeding. She came through that surgery, only to face a new emergency a short time later: a leaking bile duct, and another surgery. A few weeks after that, she needed a third surgery because necrotic liver tissue was festering, according to Ms. Crocker. The experience was devastating for this woman; still, she saw her surgeon as her champion.

    Once she had healed sufficiently from the three surgeries, the woman was referred to a highly respected plastic surgeon for reconstructive work. She was excited, Ms. Crocker says, to travel by plane to consult with the surgeon. The experience, however, took an immediate bad turn.

    "She went into the [plastic surgeon's] office and the nurse told her to undress and stand up on a small pedestal with a sheet wrapped around her. When the plastic surgeon came in, he asked her to drop the sheet and walked around her body and looked at the damage that had been done," Ms. Crocker relates. While she was still standing there, the surgeon said that he could fix her, putting her back into her 28-year-old body, but he would not because her insurance plan would not pay him enough to maintain his lifestyle. The woman, vulnerable and traumatized, got dressed and was leaving the office when the surgeon called her back and asked who had referred her. She told him that her uncle, a physician, had. The surgeon said, in that case, the two should talk. "She somehow had the presence of mind to know that she wanted nothing to do with this man, so she left. She ultimately found another plastic surgeon who did a great job," Ms. Crocker says. "The physician seemed to have no appreciation for the tenderness of the experience. She left, even when he said come back. She valued herself enough not to enter into a relationship with somebody who was prepared to reject her in the first instance."

    5 PRINCIPLES TO COLLABORATE BY Even when treatments and therapies are elective, patients are psychologically and physically vulnerable, placing their trust in their physicians' hands, literally and figuratively. The doctors featured in the book for their successful collaborations had a common perspective, according to Ms. Crocker. They viewed the relationships with patients as a privilege. And they viewed their own role as one of service. Based on their interviews, the authors devised five principles that promise to create better collaborations between health care providers and their patients.

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    Lisette Hilton
    Lisette Hilton is a writer in Boca Raton, Fla., who heads up her company, Words Come Alive.

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