Advice to Junior Rheumatologists

The following is a concise list of general advice to practicing rheumatologists/physicians that I have learnt from my esteemed professors and over years of practice. I hope other rheumatologists will find them of benefit to them in their practice too.

Listen to patients:

Although doctors might sometimes diagnose patients as they walk in through the office door (patients with ankylosing spondylitis for example who walk in stooped forwards) or when they have spoken only a few words, yet it is important that doctors listen to all or at least most of what patients want to tell them about their symptoms. Patients are not doctors; they don’t know which piece of information would be relevant and which would not be relevant in helping the doctor with the diagnosis. So they keep on saying everything.


At the same time, many of them have their own beliefs and conceptions about their illness and causation of their symptoms that, although scientifically might be funny, yet they make so much sense and logic to the patients themselves. So it is always acceptable (within limits of course) that patients take the chance and reveal the details that they believe might be related to their symptoms. Listening is not only to diagnose. It is also to manage. Patients feel better when they have vented out and have expressed all the irrelevant-to-you information that they believe might be very relevant to their illness. One important reason why patients change doctors is that previous doctors did not listen to them which, to the patients, always meant those doctors did not care. 

Be considerate:

During making rounds with colleagues and juniors at your hospital, don’t refer to a patient by his bed number or refer to him as “this case”. Patients consider this very impolite and very inconsiderate to them as human beings. Always refer to the patient by his/her name or precede it by the appropriate title according to the culture. For example, in Egypt, you can say “Mr. Ahmed is suffering of…” or “Brother Ahmed is suffering of …” Patients really appreciate that respect and consideration. Likewise, in the Egyptian culture, it is not appropriate that you call a female patient “mama” or a male patient “baba”.

 Create rapport:

Invest in creating rapport with your patients. Patients tend to open up and be more cooperative with doctors who are friendlier. If you care for your patients, you will find ways to create rapport with them and will find more ways with time and experience.

Don’t speak badly of other health care professionals to your patients:

If you have any reservations about other doctors’ prescriptions or lines of treatment but you still believe those treatments are not scientifically inappropriate or are not unethical, then keep your comments for yourself: First of all, good people, doctors or non-doctors, don’t speak badly of other people. Second, speaking badly of your colleagues will only make patients lose trust in all doctors, including you, and in their treatments and will make you lose their respect.


If you feel that other doctors’ treatments or practices are unethical or you have evidence for their malpractice, refer to the Medical Ethics Manual at your hospital or syndicate to know how to deal with such issues which, in all cases, are still beyond the scope of your relationship and communication with the patient.

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