Timely review

Judy Siegel-Itzkovich’s timely book review (“Doctors’ journey to 21st century,” Health, April 23) discusses an important issue to improve medical care and patient relations.

Rapport is an important part of the diagnosis process. The most revealing statements by the patient are often made at the end of the visit: “Oh, by the way .... ”

Physicians are typically dedicated and hard working. However, bedside manner and empathy are often inadequate. The 15-minute office limit does little to ameliorate this deficiency. Costs are kept down, but the time to achieve any rapport with the patient is limited. In addition, physicians have become defensive because of the threat of malpractice cases. As a result, they may be hesitant to be completely open with their patients.

I knew a young man who was a student at a major US medical school. Midway through his training, he developed leukemia and became a patient for two years until his passing. Before his death, he wrote a book about his experiences in both situations. Only then did he realize that training toward understanding the feelings of patients had been deficient in his preparation to be a doctor. GARY STEINMAN

Jerusalem The writer is a retired physician.