When the Doctor Isn’t the Only Expert: Finding Wisdom in Patients
– Greg Kutcher, MD, JGP Medical Journey Strategist
“I was so much older then, I’m younger than that now.” ––Bob Dylan, My Back Pages
Let’s be honest—doctors sometimes wonder why patients don’t follow what seems like the best advice. We’ve studied, trained, and stayed up to date, but people still make choices that don’t always seem right.
In my 30 years as a family doctor and hospice practitioner, I’ve seen this happen a lot. I know other doctors have too. It’s frustrating when patients don’t listen, and things turn out badly. It can be stressful, make us angry, and leave us feeling helpless. Over time, it can even burn us out.
But I’ve learned that sometimes the best wisdom comes from the patient, not the doctor.
As doctors, we’re trained to be the experts. Patients come to us for answers, and we try to solve problems, give the best advice, and offer the “right” options. But over time, I’ve realized that the right answers don’t always come from our training.
In Cancer Consultation: A Patient Artfully Tutors an Oncologist, a doctor shares a story about a patient with stage 4 colon cancer. The doctor thought he did everything right—he explained the treatment options, laid out the pros and cons, and didn’t pressure the patient. He thought he’d done a good job.
But a week later, the patient sent a letter that started, “Dear Doctor, thank you for your time. You are very knowledgeable.” (You can almost feel the hidden message here, right?) The letter included a hand-copied 19th. Century poem by Thomas Moore about fading memories and loneliness. The patient also shared that he planned to return to his homeland and be buried near his ancestors and an old love from his youth. He didn’t have anything keeping him in America.
Looking back, the doctor realized he’d missed something important. He thought the patient only wanted treatment options, but the patient had other concerns that the doctor hadn’t even thought to ask or listen for. The poem was the patient’s way of saying, “There’s more to my story than just the cancer.”
Reflecting on this experience when he was much younger, the doctor said, “I’m grateful that this retired laborer thought I was worth the tutoring. I like to think it was effective.”
The truth is the wisdom to make good choices is often already with the patient. We talk about “shared decision-making” in medicine, but it’s not always easy. At the Journey Guide Project (JGP), we help patients become experts in their own stories. And we help practitioners learn to listen more, step back, and see that their knowledge is only part of the whole picture.
It’s not easy, though. The system often pushes for clear answers, even when things are uncertain, and values numbers more than personal stories.
So maybe the real lesson here is that being a great practitioner isn’t just about having the right answers—it’s about asking the right questions and letting the patient’s story lead the way.
