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Do You 'Kitchen Table' Know Your Patients?

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One of my favorite TV characters is Cliff Clavin, the know-it-all mailman on the TV show "Cheers". I really like his quirky sense of humor and affection for interesting, but useless facts. When I was in medical school and transcribed class notes to make extra money, I would put some Cliff Clavin-style worthless bits of trivia at the end of the notes, just in case someone in my audience appreciated the comedic relief of an otherwise grueling three pages of histology notes. I remember one episode of "Cheers" in particular, in which Cliff is on Jeopardy! and is given the final Jeopardy! answer of “Archibald Leach, Bernard Schwarz, and Lucille LeSueur". He answers with the question, "Who are three people who have never been in my kitchen?" His answer is hilarious because technically, he is correct. The more implicit point is that, while these people are famous and we might think we know a lot about them, we don’t know them well enough that they have been in our home. We don’t have a "kitchen table" relationship with them.

Current events have me thinking about my relationships. Who do I know and who do I kitchen table know? Particularly for my patients, I would say I know them very well, given the confidential and innermost experiences they have shared with me. Yet, none of them have been in my kitchen.

That is, until now. 

The pandemic has forced many of us to practice medicine in nontraditional ways. In our physician-owned multi-specialty group, three primary care physicians were tinkering with virtual visits before the pandemic. Within 10 days, we now have 130 physicians doing many virtual visits per day. The volume of our in-office visits was immediately slashed to 50% at the least. Virtual visits were the only tool we had to take care of our sick patients, keep them at home, and still maintain productivity.

It also brought an unexpected dimension to the relationships I have with my patients. Even though it is virtual, there is an intimacy with my patients that an in-office visit doesn’t have. I am connecting with them right in their kitchen. And they are connecting with me in mine. I never would have guessed that the 48-year-old serious, always impeccably dressed banker would have a collection of Superman magnets on his refrigerator. My 74-year-old widowed patient has an obvious love of butterflies, as evidenced by the theme in her kitchen. They are probably looking behind my shoulder and seeing what is in my kitchen: The artwork of my children scotch-taped over every square inch of one wall. A Dr. Seuss vowels and consonants poster. A table with Legos strewn everywhere. They are seeing me in my element as a mother, probably quite unlike the professional image they had of me in my office. 

Even though I have known some of them for years, in some ways it is like I am learning about them in a completely different way. As a primary care doctor, I appreciate knowing those seemingly useless facts about my patients because it enriches my understanding of them as a person.

This pandemic has been incredibly challenging and devastating, but we have seen many good stories come from it. I have gained a deeper relationship with my patients by virtue of virtually being in their kitchen. For the first time in history, the majority of people on the planet have been thrust into a forced, simultaneous time out. Let’s not view it as a punishment, but rather a time to strengthen relationships and connect with others in ways we never have before. Who can you virtually invite to your table? Perhaps you will have the opportunity to be in your patient’s kitchen. If you take the time to observe, you will learn something more about him or her. When this pandemic ends, I hope we will all better appreciate these kitchen table relationships. 

Sara Bajuyo, MD is a family physician who practices in South Bend, Indiana. She has five children and enjoys creative writing in her very little free time.

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