Dr. Carmen Landau was passionate about improving the way health providers interact with patients. It spurred her to write the book “Unharmed: Why People Are Afraid of Healthcare and How Providers Can Bring Healing into the Exam Room.”.
Unfortunately she died unexpectedly shortly after completing the manuscript. So her sister, Marie Landau, turned her professional training as an editor to the task of getting the work published.
“I picked up the project after she had passed away, and then published it this last August,” Landau said.
The book has sections aimed at both health care providers and patients. It identifies the discomfort that patients have with doctor visits as going far beyond fear or a diagnosis or a procedure.
“I think that the number one thing that Carmen advocates for in the book is understanding that no matter what background your patient is coming from, there's an automatic power disparity between the patient and the provider,” Landau said. “One person is in a position of power and the other person is very vulnerable, and so that can make communication difficult.”
People who face social marginalization for things like their weight, a disability, a history of drug use, or sexual activity often find that same social prejudice can follow them into the exam room. Landau’s book points the way to recognizing and removing these barriers to providing ethical and effective health care.
“The message toward patients is like, you don't need to accept this as normal, and you're not alone,” Landau said. “But the primary messaging really is for providers. And she wanted to try to get this education into medical schools, into residency programs, into clinics, so that providers can start to change the culture. Because although patients are also an audience for this book, it really is incumbent on the medical profession to change the way that they do things, so that they're doing the work, instead of putting that burden on patients.”
Women’s concerns are a focus of the book, which includes chapters on the role of doulas, and how to make pelvic exams and procedures more comfortable. Other chapters address how a personal history of rape or sexual assault can make medical visits harder.
Landau said that parts of the book were written with the idea that topics from the text could be shared by patients with their medical providers.
“And she actually advocates in the book, ‘feel free to show this chapter to your provider, and if they're offended by it, you might want to think about getting another doctor,’” Landau said.
