Doctors and Patients Can Team Up to Listen For Healthier Outcome
by Rebecca Shafir
For Health Care Providers (doctors, nurses, therapists, social workers, etc):
·Allow 45 seconds of mindful silence while the patient tells why he/she is here (the average time to interruption by a doctor in a doctor-patient interaction is 14 seconds or less. Resist jumping in during the gaps. Those few seconds in between may lead you straight to the diagnosis saving patients a lot of time, discomfort and money.
If a patient gives you conflicting information, that is, if the verbal signal conflicts with the non-verbal signal – the non-verbal message is probably the right one.
Encourage patients to be partners in their healthcare: “Here are the treatment options based on XXX, how would you like to proceed?” or “Of all your health concerns, which is the most important to you?” Help them prioritize. When you create a climate of openness and teamwork, patients will feel safer to report their successes and failings in following through with their treatment plan.
Treat each patient like as if he/she were one of your most cherished family member. Grumpy Mr. Abernathy may not be your Dad, but he is probably somebody else’s.
Accept the patient’s reality that his/her situation is upsetting TO THEM. A marathon runner prior to race day with a torn hamstring can be as devastated as a person diagnosed with cancer. Patients resent us when we judge their perception of the problem.
Sometimes patients will get off track and have trouble getting to the point. If you see this happening, allow about 20 seconds or so for them to get to the point, then raise a finger, then say, “Mr. X excuse me, but let’s get back to why you’re here today.”
If you have set the stage for care and respect early on, patients will rarely be offended by this urge to get them back on track. (I can recall only once when this request backfired, and the patient was miffed because he was sure that tracing back aloud his family’s medical history since 1900 would reveal the true source of his chronic hoarseness.) Understand that their visit with you may be the only quality, personal time they have spent with anyone in months.
For Patients
Accept the reality that the doctor can/will only spend 10-12 minutes with you per visit. If you prepare well and are ready to participate as a team player in your health care, you can get an hour’s worth of quality in a very short period of time.
Prepare your questions ahead of time. Prioritize the top two health concerns for the immediate visit. Leave the rest of the list in writing or in an e-mail for your HCP to look over. He/she may suggest a re-ordering of priorities, so the list is helpful. But, avoid lengthy narratives unless, your doctor requests.
Most doctors appreciate patients who have done their homework (i.e. on the Internet) to better understand their diagnosis and treatment. But keep in mind that aside from the helpful and true information, there is a lot of bad advice and hearsay on the Internet. As a partner in your care most doctors don’t mind discussing a new study or approach to treatment you’ve discovered. But because time is limited keep the discussion brief and leave behind a copy of the study or article for them to review when they have more time.
Ask for clarification of unfamiliar medical terms and medications. At the end of the visit, sum up your understanding of the HCP’s advice and next steps for treatment, if any. Tell back to your HCP in a couple sentences how you understand the problem and possible solutions.
If you choose to bring another family member in with you, agree on the points to discuss with the HCP. Agree to leave non-health related disagreements at home. The office visit is not the time, nor the place for family disputes.
Even the most comprehensive examinations can have mistakes. To catch errors in reporting ask for a hard copy of the specialist’s report before it goes to your PCP or a surgeon. Be sure that the information you supplied the specialist was accurate and that it was correctly interpreted. Pointing out inaccuracies rather than finding fault can help avoid costly medical errors.
Remember you are the customer! If you have followed the above guidelines and still feel you have not been heard, notify a patient advocate in hospital administration. It’s your health and well-being at stake!
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