HEALING PEOPLE, NOT PATIENTS- a book review

A couple of months into medical school, Dr. Weinkle interviewed a distressed patient in acute alcohol withdrawal. He tried to develop empathy for the man as he unraveled his long history of alcohol abuse and explored his reasons for trying to quit. However,as he proceeded to examine the patient, his empathy evaporated when the man rolled up his sleeve for a blood pressure check- revealing a huge tattoo of a Nazi swastika.

Creating Authentic Relationships in Modern Healthcare.

In HEALING PEOPLE,NOT PATIENTS Dr. Weinkle describes ways he believes the current healthcare system in our country  fails to meet the needs of both patients and physicians. Reading it, I thought of a new television medical drama in which a determined, idealistic young doctor fights a bureaucratic system to care for  disenfranchised patients. Critics call the show unrealistic, but if they read Dr. Weinkle’s book, they may decide it’s not so far fetched.

The author,  Jonathan Weinkle, M.D. , FAAP

Dr. Weinkle practices primary care medicine at Squirrel Hill Health Center, a federally qualified health clinic in Pittsburgh Pennsylvania. He  serves as Clinical Assistant Professor of Pediatrics and Family Medicine at the University of Pittsburgh, where he also attended medical school. He lives with his wife and three sons.

Dr. Weinkle contacted me after reading  my review of a book by Dr. Danielle Ofri. He asked if I would consider reading and reviewing his book also.  I agreed, and he provided a complimentary PDF copy.

Pitchwerks podcast - #115:Dr. Jonathan Weinkle
Dr. Weinkle’s podcast


Why our healthcare system is broken

One problem, he says,  is the EHR -electronic health record, which doesn’t allow him to express himself the way he would like. He prefers to


open a patient’s (paper) chart,(so it) tells me a story about the patient much like he might tell himself, almost as if I am reading a medical memoir

Although he calls this book  a “how to”- how to restore the sacredness of the doctor-patient relationship– it also  reads like the “medical memoir” he prefers for a patient. It’s his memoir, a telling of his journey from a  medical student entering the “adventure” of medicine to a graduate physician who believes


“Practicing medicine is a privilege, a gift- a sacred trust.

He illustrates several issues plaguing modern medicine using anecdotes about patients from his practice (with details changed to preserve privacy and confidentiality). Our current medical system sabotages   healing by

  • Fractured communication
  • Muddled priorities, where paper work takes precedence over patients
  • Procedures valued over counselling
  • Volume incentivized over value
  • Turning humans in pain into consumers, “as if they were buying televisions”

A turning point and lesson learned

A couple of months into medical school, Dr. Weinkle interviewed a distressed patient in acute alcohol withdrawal. He tried to develop empathy for the man as he unraveled  his long history of alcohol abuse and explored his reasons for trying to quit.

However,as he proceeded to examine the patient, his empathy evaporated when the man rolled up his sleeve for a blood pressure check- revealing a huge tattoo of a Nazi swastika.

Dr. Weinkle is Jewish.


“I am not a vindictive person, but all I could think was, “Well, it serves him right. This is poetic justice.”

He excused himself, never telling his preceptor how ill it (the tattoo)  made him feel, or the malicious thoughts it triggered in his mind.

In HEALING PEOPLE, NOT PATIENTS, Dr. Weinkle explains how he learned to change those kinds of encounters into ones with


Open, honest communication, mutual respect, and shared purpose, even when systemic problems push them into adversarial positions.

But it’s not easy.


even when everyone has the best of intentions,
building a covenantal relationship in the current healthcare system is about as easy as
building a house on the Carolina coast and not having it destroyed by a hurricane.

a male doctor talking to a middle aged woman
Photo by Dr. Weinkle’s son, used by permission

How to fix our healthcare system

One way he makes it happen is by working in a Federally Qualified Health Center, FQHC.

A FQHC is the closest thing we in the U.S. have to “socialized medicine.” Dr. Weinkle has worked in one for 10 years. As he describes it, in a FQHC

Anyone who is a stranger to the healthcare system, who has to clear high barriers in order to access care, should be welcomed in and have help knocking down those barriers.

Most doctors  concentrate on helping patients manage acute and chronic disease and try to address the major causes of disease and death -smoking, poor eating, lack of exercise, stress, sleep deprivation, substance use, and obesity. But doctors like Dr. Weinkle tackle other challenges , the “social determinants” of health. These include

  • Inadequate houses or homelessness
  • Lack of reliable transportatin
  • Unsafe neighborhoods
  • Food Deserts, where healthy food is unavailable
  • Language, ethnic, or cultural differences
  • Discrimination and/or exclusion
  • Unemployment, low wages, and/or poverty
  • Limited education and/or education opportunity

His patient panel consists of people who are

  • Refugees, who often speak little or no English
  • Members of ethnic minorities, including African Americans and Hispanics
  • LGBTQ persons
  • People who are mentally ill and/or developmentally challenged
  • People with stigmatizing illnesses, such as HIV/AIDS
  • People with substance abuse
  • People who have been incarcerated


Dr. Weinkle feels at home taking care of them because

“I come from a long line of people who have been strangers in a long line of places. We are supposed to understand how it feels to be shut out, demonized, misunderstood, or simply ignored.”

Since I finished residency many years ago,  I have had limited experience treating these types of patients, but enough that I understand the challenge, frustration, and sometimes satisfaction of doing so. Non medical professionals may be surprised by Dr. Weinkle’s descriptions of dealing with patients who are often unable or unwilling to cooperate with even basic healthcare steps.  

American medical care has transformed in the past 50 years but most of us wish it still worked like in the “good old days. As Dr. Weinkle describes it


most doctors were solo practitioners who did everything, and a patient, especially in a smaller town, could expect care that felt like home.
Continuity throughout their life… and accompanying them through
old age.
Presence wherever and whenever it was needed, in the middle of the night,

Unfortunately, medicine in the 21st century doesn’t look like that because


There are too many different kinds of care,… and too many demands on a doctor’s time to enable this kind of practice ..


Hospital privileges, insurance credentialing,

and the simple fact that doctors have belatedly learned that we can’t work 168-hour weeks and maintain our own health and family relationships

prevent us from being like our favorite docs of yesteryear.

Dr. Weinkle’s practice uses the concept of a “medical home”, often called the patient centered medical home, PCMH, which many medical offices are adopting, not just FQHC. But it is especially important with patient groups like the ones he and his colleagues care for.

(The concept of PCMH is explained here Defining the PCMH )

He takes it one step further, writing we need more than medical homes, we need medical communities, where doctors work closely with their local hospitals, ERs, pharmacies, and schools to address patients’ needs.

a male doctor examining a smiling baby girl
Dr. Weinkle’s baby girl patient seems to be enjoying her visit. Photo by the girl’s father, used here by permission. When posted on Facebook, this photo received 4000 likes in one week.

The solution- covenant health care

In HEALING PEOPLE, NOT PATIENTS Dr. Wrinkle argues for creating authentic relationships in modern healthcare by  

Promoting health behavior change without insulting or scaring patients, by learning what obstacles they face and helping to resolve them

Honesty about disease outcomes, especially at the end of life; avoiding futile care, and recognizing that sometimes death is not a complication but is the ultimate outcome of some illnesses

“Activated patients”  determined to get better,  to do something about their illnesses, becoming experts on their diagnoses

Doctors and patients valuing and respecting each other’s time and knowledge

Cutting waste- eliminating those things we do in healthcare that don’t add value to care, making it safer or more effective; bureaucratic policies, procedures, and rules that waste both time and money, like prior authorizations, “utilization review”, and 15 minute appointments

Medical education that includes teaching interpersonal skills, with learning objectives given as much importance and time as other medical skills,

Ultimately, Dr. Weinkle wants to see medical care return to being


meetings between two human beings, together forming a covenant to achieve healing

That concept is partially born out of Dr. Weinkle’s Jewish roots discussed in the Appendix- Being a Nice Jewish Doctor

“God forms a covenant—many covenants, actually, sealing the promises with symbols like rainbows (Genesis 9:13), circumcision (Genesis 17:10), and stone tablets engraved with the law (Exodus 24:12).

Image from Lightstock.com, stock photo site, affiliate link

The essence of the Jewish faith, the place where a Jew’s worth as a person is tested most thoroughly, is in the relationship with God—and the parallel relationship with other human beings made in God’s image. ”  


Why you should read HEALING PEOPLE

Health care professionals will find Dr. Weinkle’s concepts an attractive alternative to “burnout”, an encouragement to remember why we entered the profession in the first place, and a challenge to restore the personal touch that makes medicine truly an art.

Patients will find explanations about why medical care is at times fragmented, uncoordinated, and unproductive, will understand the challenge that their own physicians face in providing effective care, and understand how they can be part of the solution.


The book concludes with  an extensive list of Notes listing the references used in each chapter and an exhaustive list of References and Suggested Readings, a few of which I will include below.

Here is a link to Dr. Weinkle’s website where you can read excerpts from the book.

Healers Who Listen

An unexpected connection

You may recognize Dr. Weinkle’s practice location as one that was recently in the news.

a building with sign-Squirrel Hill Health Center

Squirrel Hill is considered a historic center for Jewish life in Pittsburgh. It is home to more than a quarter of Jewish households in the Pittsburgh-area, according to a Brandeis University study of the Greater Pittsburgh Jewish community.

This is also the Pittsburgh  neighborhood where a gunman walked into the Tree of Life Synagogue and opened fire, killing 11 people on October 27, 2018.

I had only exchanged one email with Dr. Weinkle so it wasn’t until a few days later that I made the connection. I wrote to him and was relieved to learn he was safe.  He had attended a Bat Mitzvah there just the week before the attack. Some of the victims were friends and colleagues.

More of that story is at this link.

Squirrel Hill Mourns

Suggested resources

Here are a few of Dr. Weinkle’s recommendations; please note these are affiliate links which help me fund this blog.

sharing the HEART of Healing People, Not Patients

Thanks for joining me to meet Dr. Weinkle and review his book.

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

I would love for you to start following Watercress Words : use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha 

3 keys to effective communication with your doctor

Expressing feelings honestly and respectfully, and listening with empathy and respect can build the trust that is vital to creating a connection for effective information exchange – communication.

Surveys suggest doctors and patients often fail to communicate effectively, so public and private medical organizations have implemented programs to improve “patient engagement”. But what exactly does that mean?

The communication problem

Patients may feel that doctors don’t listen to them, ignore their questions , dismiss their concerns, don’t spend enough time with them, and don’t use language they can understand.

Physicians wonder why patients withhold important health information, fail to follow up with recommendations, and don’t ask questions or express their concerns.

The main problem with health care communication is that it involves people- and people frequently communicate poorly, and sometimes not at all. It never will be perfect. But we can do better.

So what is true patient engagement anyway?

Dr. Rob Lamberts writes

“Engagement is about interaction, listening, and learning in relationship to another person.”

Barbara Ficarra, R.N. , puts it this way:

Patient engagement is a connection between patient, caregiver and health care provider.

Patients and their families are empowered and they are active in health care decisions.

Those patients and consumers who choose to be actively involved and in charge of their health work together with their health care providers to successfully rech their health goals and needs. “

To make healthcare interactions more effective, efficient, and empowering, both doctors and patients need to develop skills that may be different from what they have done in the past.

What is communication?

to convey or exchange information, thoughts and feelings.

to join or connect.

Communication is a connection allowing access between persons

doctor holds patient's hand
on a mission trip to Mexico; photo by Brian Edgerton

Establishing a connection, or relationship.

If we try to start exchanging information, or even thoughts and feelings before we have established a connection, it is like to be unsatisfactory.

For example- think about a recent retail service experience – one that worked and one that didn’t. Perhaps it was a call to customer service to get a phone service problem resolved. Or maybe you went to a car dealership and interacted with a sales person. Whatever the situation, and whatever the outcome, you probably rated it more favorably if you felt connected with the person helping you.

Recently I called my medical insurance carrier to resolve some unpaid claims- and my insurance is through a government agency. I dreaded the call, expecting a difficult unpleasant conversation. But the rep was professional, efficient and confident. She started immediately by telling me her name and position, then asked me my name. She then accessed and reviewed my account, giving me feedback about what she found. Then we started working on my problem, and continued until it was resolved. I was surprised to have the situation taken care of not only efficiently but pleasantly.

In dealing with others be willing to be frank , flexible, and forgiving.

the who of connection

Customer service depends on connecting, and that usually starts with knowing who you are dealing with. The first item we exchange in any human interaction is usually our name.

Dr. Oglesby nametag

You should learn your doctor’s name and credentials-M.D., D.O., and specialty- internal medicine, cardiology, psychiatry, etc. in other words, what kind of doctor are they?

What is this doctor’s role in your care? Is this doctor primary or a consultant, and what issues are each managing? (especially in a hospital situation)

Tell your doctor what name you prefer to be called if it’s different than the name on file. Your doctor should know who is your legal next of kin or who has POA (power of attorney if applicable)

Introduce other family and friends and identify the primary contact person; this first level of receiving and giving information, is especially important in the hospital setting. This will create continuity as the doctor speaks to the same person every day.

If you take a friend or relative to your doctor’s office with you, make sure they understand what their role is. Your family’s insights and observations provide helpful information to supplement what your doctor learns from you. They can help you remember and understand answers and instructions. But this isn’t a time for them to discuss their own medical issues with the doctor.

the where of connection

Where you interact with your doctor, is important as interaction may be quite different in a private office setting vs an urgent care clinic vs an emergency room vs inpatient. But general principles apply to all settings.

Approaching others with generosity, grace, and gratitude makes it easier to connect.

EMERGENCY-sign
Photo by Pixabay

Ideally it should be as comfortable as possible, private, and quiet, so you can hear and see each other well.

Friendly greetings are fine anytime you encounter your doctor, but discussions of personal medical information don’t belong in the hallway, elevator, or cafeteria. Likewise, if you run into your doctor at church or the grocery, just say hello.

the how of connection

Come to an office visit prepared. If you have test results, previous medical records, xrays, etc. bring them with you. Not all doctors will request it, but most will appreciate an up-to-date list of all medications you take, or even bringing the meds with you. Turn off your phone.

Expectations about time can create conflict, whether the visit lasts longer or shorter than you expect. If you weren’t told, ask the office how long the appointment is for, realizing that it will only be an estimate; it will depend on what you and the doctor end up discussing and what you need done.

Showing up on time helps the office keep to their schedule and shows the doctor you are serious about your care and respectful of other patients’ time. If the office is consistently poor at time management, address it respectfully; sometimes it is best to move on if this continues to be an issue that bothers you.

Most hospitals and clinics have abandoned paper charts for computers, using electronic health or medical records- EHRs or EMRs. I’m not going to dwell on it now, but computer use in the exam room or bedside has changed the dynamic between doctors and patients in ways that were unexpected and challenging. Here is the link to a post I did addressing the issue of

Electronic Health Records- Challenges and Changes

Stethoscope on the keyboard of a laptop

the value of connection

Connecting with your physician depends on acknowledging feelings- worry, fear, despair, hope, relief, anger, resentment, frustration. Give feedback respectfully; if anything about your care is not as expected, or doesn’t seem appropriate, or you just don’t understand something, speak up.

Expressing feelings honestly and respectfully, and listening with empathy and respect can build the trust that is vital to creating a connection for effective information exchange – communication.

a male doctor talking to a middle aged woman
Dr. Weinkle with a patient

Dr. Jonathan Weinkle discusses connection and relationships in his book

HEALING PEOPLE NOT PATIENTS: Creating Authentic Relationships in Modern Healthcare

which I reviewed at this link.

exploring the HEART of communication

You can connect with me, here and on social media. If you have found something helpful on this blog or have a topic you would like to know more about, contact me.

I would love for you to start following Watercress Words : use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha