'Doctors harm people all the time without knowing it'

As a GP, Dr Lucy O'Hagan meets people every day whose bodies carry "big stories" of trauma - one day, that was three different patients who'd had a family member murdered.

While O'Hagan can't always offer them hope, she tries to honour the mana of each patient by celebrating their personal strengths - something many people in the 86-percent Māori and Pasifika community have not experienced from a Pākehā GP.

"If I tell them how amazing they are, that's really powerful because people like me don't tell them that," O'Hagan tells Saturday Morning.

Health problems are a lot easier to deal with if you've got a warm house and food on the table, O'Hagan says.

Although most middle-class Pākehā know how the health system works and how to ask a GP for what they want, she says it's a "very different ballgame" for many people in Porirua.

"They don't have any sense of entitlement to anything like this."

Although Māori and Pasifika doctors are now transforming the face of healthcare, the communication skills taught in med school still tend to be "quite Eurocentric", O'Hagan says.

Accordingly, the power a doctor has over a patient can be "really badly" misused - without them even being aware of it.

"Doctors harm people all the time. They don't even know they're doing it, just in the way that they speak and in their whole energy, but you can use your power in a different way."

People have to be able to trust doctors, she says, but this doesn't happen unless some kind of relationship is established.

To fast-track this and connect to a person's story, she now tries to get a sense of their mauri [life force] and "energy" as soon as she spots them in the waiting room.

"Doctors need to see the mana [power] in each patient."

Although people who appear "professional", like GPs, are viewed as trustworthy by some New Zealanders, O'Hagan says that for many non-Pākehā, it's the opposite.

"Someone who looks professional is not trustworthy because they look like the people from Oranga Tamariki or the police or whatever."

To better understand the role she is playing within the patient's "story", O'Hagan, who has now been a GP for 35 years, flips her perspective.

"I'm a character in a story, and what story am I in with this person? I mean, I'm still me, but how do I modulate my character for the situation I'm in?"

As "another character in the room", doctors inevitably bring their own personal stories into interactions with patients, O'Hagan says.

"Even though we don't speak them or say them, I think that people sense them enough. They are sensing, is this a person who I can trust with my story?"

Many New Zealanders don't have automatic faith in the biomedical model, which is based on "a very Western way of thinking".

"[A Māori patient] is going 'Well, why would I take four pills when I feel perfectly well? You're telling me to do that, and you're this old Pākehā lady. Do I trust an old Pākehā lady, anyway?'"

For a GP, practising medicine while simultaneously taking in a human story is an "incredibly complex" task.

"Medicine is so rational and cognitive, and you're supposed to know what to do, and the story is sort of sensate and subjective… You're simultaneously in these very different parts of yourself."

While doctors have traditionally had "really odd, formal relationships" even with each other, O'Hagan doesn't shy away from her personal struggles in her new memoir.

In Everything But The Medicine, she writes about her brother's death, her son's epilepsy, and the "very high sense of shame and failure" that followed her burnout in 2015.

"[Doctors] are also human beings… I don't mean that in the sense that the patient has to look after us. I mean that in the sense that we need to look after each other."

Check out Dr Lucy O'Hagan's tips for getting the most out of your doctor's appointment here.