Stacy Serber, PhD, a Stanford Heath Care clinical nurse specialist, struggled with being overweight for much of her life, but everything changed when she started seeing Megan Mahoney, MD, clinical professor of medicine.
Clinicians across the board say the current climate of medicine cuts into the time they can spend really listening to patients, which makes it difficult to build trusting relationships that are at the heart of good health care.
To Serber, finally finding success in losing weight is the result of how Mahoney approaches their relationship and Serber’s wellness. “It’s more than, ‘What are your medical problems?’ She listens and she meets me where I am,” Serber says. “I’m the kind of person who can dig in my heels. But she doesn’t tell me what to do. She doesn’t browbeat me. She takes time with me and I never feel rushed when I’m with her.”
Mahoney, who is the section chief of general primary care in the Division of Primary Care and Population Health, recommended during their first appointment together that Serber see a nutritionist to help her lose weight, but Serber declined. Mahoney gently pushed back: “It’s something I would like you to do. If you’re not comfortable, we’ll leave it at that. But would you be comfortable revisiting this in six months?”
Serber agreed. And when nothing changed in six months, she agreed to see the nutritionist and enrolled in Stanford’s Omada Health program, which helps people who are at risk for diabetes and heart failure because of weight make long-term lifestyle changes.
Serber lost 54 pounds in a year. Along the way, Mahoney cheered on Serber’s successes and focused on Serber’s goals and challenges.
Mahoney says she finds immense gratification in having that kind of experience with her patients. “That’s why I became a doctor.” She also wants patients to know “they’re walking this journey with somebody.”
“I want people to leave feeling better, not from their symptoms, but because they had a connected experience with someone they could trust — that they felt like they were heard, that we came up with a plan together, and that they were participants in developing the plan,” Mahoney says.
For some patients, it takes more digging to get there. If, for instance, a 30-year-old, fit man is having chest pains and his biggest fear is that it’s a heart attack, she can’t just do an EKG, say, “No, you aren’t,” and send him away. She has to address “the question behind the question.” Maybe his best friend just had a heart attack.
“If you aren’t addressing the fears, concerns and expectations of the patient when they come in for the first visit, they’ll come back for another visit,” Mahoney says.