Patients want to trust that their physicians aren’t judging them or talking about them behind their backs


Credit: Monceau

Getting the opportunity to come back to Pittsburgh after four years of undergraduate work there was incredible. The city has come so far;  it’s slowly growing into one of the more popular destinations in the nation and I couldn’t be happier about it. So participating in the Scaife Advanced Medical Student Fellowship in Alcohol and Other Drug Dependency was a great chance to enjoy a lovely city in addition to broadening my horizons on the subject of addiction.

There was no time to be shy. On the second day, we were given a pair of standardized patients and asked to motivationally interview them. For those unfamiliar with this technique, it is simply a way to gain the patient’s trust in a short period of time with the desire to focus on the patient’s own intrinsic motivation and set goals for their ultimate recovery from whatever issues they may face.

At first, this seemed to be quite the intimidating task. I remember walking into a brightly lit room to encounter a young woman with dark sunglasses and arms crossed, completely closed off from any interaction. What in the world was I going to say to this woman to get her to open up to me? Would she be offended by my prying into her personal life? As I sat down to speak with her, my apprehension faded and slowly I grew more confident. The ten minutes we spent delving into her abusive past and drug history opened the conversation up to a plethora of issues, but sadly the timer went off and she closed herself off once again, this time preparing for the next student. Though this was a short experience, it brought to light one of the most important barriers to effectively addressing addiction in our society today: a lack of trust.

It is no secret that the scarlet letter A, this time for addiction, is quickly branded on patients who reveal that they have a problem, whether they are recovering or not. The young woman I interviewed simply wanted to trust the individual she was opening up to–which could only be accomplished if I reserved all judgment and thought no less of her than any other woman.

It became clear to me that physicians with a lack of training in the area of addiction fail to properly engage these individuals.

This initial experience was just the beginning. From there, I went on to engage with a number of current and recovering addicts at different stages of their lives. It became evident that they shared very similar views on physicians. As a future physician, it was incredibly important for me to better understand their issues and it all came back to one word, trust. Across the board, they wanted to be able to trust that the person treating them wasn’t judging them or talking negatively about them behind their backs.

On top of that, the patients really wanted their physicians to talk to them. They wanted physicians to take an extra five minutes and really understand their emotions and issues. The Scaife Fellowship gave me this opportunity again and again, and for three weeks I was able to interact with and engage patients in many settings, with many stories.

For me, patient interviewing was by far the best part of the Fellowship. It was an incredible exposure into the ups and downs of addiction. I was so impressed that patients were willing to disclose almost anything about their addiction with me, a first year medical student. To put that kind of trust and faith in me, hoping that I may one day be able to help change perceptions of addiction in our society, is amazing.

It became clear to me that physicians with a lack of training in the area of addiction fail to properly engage these individuals. By branding them with that scarlet A, they destroy any chance of recognizing the patient’s issues and offering help.  This needs to change.

The Scaife Fellowship taught me to approach addiction in many settings, skills that will definitely come into play regardless of what specialty I choose. As I learned in the three weeks that I spent in Pittsburgh: addiction does not discriminate and it is important for physicians of today and of the future to ingrain this in their memory and to never lose sight of what they signed up for from the start: to promote, maintain and restore the health of any human being.



Pavan Patel is an aspiring emergency medicine physician who is now entering his second year at Rowan University School of Osteopathic Medicine.  He participated in IRETA’s Scaife Medical Student Fellowship in June 2014.  More information on the Fellowship is available here: