While it is obvious to us that many of these folks are the worried well, the patient is truly concerned. If we fail to allay those concerns, we do the patient and his or her family a disservice. We can order a CT of the head, $1,000 worth of blood work, and an EKG—but if we don’t spell it out for the patient, they won’t necessarily be reassured.

Many times, I have explained that the tests are normal and everything seems to be OK—only to receive a vacuous stare from the patient. It is only after I clearly say that there was no heart attack or stroke or pneumonia that the patient smiles and says thank you. This I find to be very satisfying. I provided an answer to the patient’s question even though I did not make a specific diagnosis.

We send most people home with nothing more than a handshake and a dose of reassurance. The better I get at putting to rest patients’ concerns, the happier they are and the more satisfied I am. This is an important part of our art, and we should take pride in doing it well.

I find it interesting that at many institutions, someone from the shiny-shoe crowd periodically descends from the administrative offices to be sure the doctors know how to read a stool Hemoccult card. I guess this is relatively important, but in the big scheme it’s probably at the end of the continuum—near knowing how to do hospital corners on the bed.

It seems that attention to our competence at succinctly answering the concerns of our patients is infinitely more important than proving that we mastered a simple skill as medical students. When I was a director of an ED, no patient ever complained about Hemoccult reading skills. Complaints about demeanor and concern for the patient were common.

This is the stuff patients care about. They don’t care how many tests we did to get to the answer, only that there is an answer and it is communicated to them in a way they understand.

Almost all parents will be satisfied that their active toddler with the goose egg on his forehead does not have a brain injury, as long as several key words are used in the explanation. You know the reason they came is to get a CT. The art is in reassuring the parents without irradiating to death the neurons that would allow their kid to eventually understand calculus.