Physician finds that sometimes waiting is the best medicine | Expert Opinion

A patient recently came into my office to discuss pain she had started experiencing only a few weeks before. We spent 20 minutes discussing her pain, including its location, duration, and quality (what the pain felt like), and I reviewed some options for evaluation and treatment.

Then my patient asked a question I wasn’t expecting: “What if I just wait and do nothing?”

Her question gave me pause. I had made an assumption that she was hoping for treatment to happen as quickly as possible. Now she was bringing up a great point: Sometimes, waiting is the best medicine, referred to in health care language as “tincture of time.” When I asked her to tell me what she meant, she explained that she could deal with the pain without pursuing any X-rays or medication if I thought there was a chance it would resolve on its own.

“Don’t just do something, stand there!” is a saying that emphasizes the benefit of not rushing to judgment or action. Sometimes, it’s best to take a moment to breathe, calmly assess a situation, and think over the options available before jumping to action.

In voicing her question, my patient provided us both some clarity. I now understood that she felt the pain wasn’t something that needed to be managed immediately, and my patient realized that she had treatment options if she chose to pursue them. We were both able to assess the situation and not rush to further evaluation.

Reassuring my patient that this kind of pain wasn’t a “red flag” allowed us to acknowledge that we weren’t missing something dangerous. We came to an understanding that taking the wait-and-see approach was perfectly safe. We reviewed warning signs that would indicate if there were a need for more urgent care and clarified her goals for future management of the issue if it persisted.

Doctors are accustomed to trying to help our patients feel better, to try to “fix” a problem. Ideally, this is as straightforward as giving reassurance that a symptom is normal, or easily treatable. In many cases, improving our patients’ health is a much more complex and long-term process. It’s easy to assume that my patients and I share the same goals, but it’s just that — an assumption.

When patients ask a question such as “what if I wait?” it can help both of us slow down, clarify expectations for care and goals of treatment, and really hear each other. In encouraging me to take a longer-term view of her health, my patient helped us both gain a new perspective.

“Tincture of time,” or waiting out a medical issue, is not the answer to every situation, but asking the question may gain clarity for both patient and physician.

Amanda Finegold Swain is a family medicine physician who works in the University of Pennsylvania Health System.