“Steady, earnest, and energetic effort : devoted and painstaking work and application to accomplish an undertaking”
Another virtue that made my list, coming here in my restored alphabetical order, is Diligence. The dictionary suggests this to be something practiced over time and, at least in my mind, it conjures up the notion of a one-on-one relationship between doctor and patient.
Of course, we are no longer on call 24/7 and hospital medicine is often not part of a primary care doctor’s clinical duties anymore. But even if other clinicians step in now and then, we still have the longitudinal responsibility of carrying out the treatment plan and of pursuing loose ends. We may even be the only ones to recognize that loose ends even exist in a case.
Two side notes here about the word diligence: These days I mostly hear this d-word preceded by another d-word in the expression “due diligence” in legal terminology. I may be prejudiced, but when I hear that term, it gives me the flavor of a mandated process, sometimes a cursory one, certainly not something that goes on for the length of time a doctor may follow a patient with a chronic condition and/or a medication treatment that requires indefinite monitoring for complications.
The other meaning of this word was one I have known since I was a little boy in Sweden, but never realized existed in English too - I assumed it was French because of the way it is pronounced in Swedish. The dictionary phonetic and even its audio clip sounds totally French. This meaning of the word is stagecoach. The -gence ending of the word diligence in this case is pronounced like the beginning of Champs-Élysées.
Anyway, in the medical context, diligence, to me, implies steadfast, ongoing attention to detail, not losing track and not giving up, not being complacent. Our culture has a short attention span and what doctor hasn’t seen that patients often drift away from their treatment plans. It is our job to touch on the elements of our treatment plans when we see our patients in follow-up.
I also think diligence is the way we act on our curiosity. Instead of idly wondering about what our patient experiences for symptoms or manifests in their test results, we need to look it up, as I did in my post about Curiosity the other day.
This reminds me of a case I saw many years ago, a seemingly simple case of a woman with a yeast infection. She turned out to have glucose in her urine all the time but never an elevated blood sugar. This was before Farxiga and Jardiance came on the market, causing this to happen both in non-diabetics and to a greater degree than normally expected in diabetics. I tried, without success, to get the nephrology clinic to evaluate my patient, whom I only saw once as an urgent care case and could have treated for her yeast and put her out of my mind. But my curiosity made me at least try to pursue it.
Here’s that story:
https://acountrydoctorwrites.blog/2018/03/02/one-more-question/