Watch this video and then we’ll talk.
Guilty pleasure, I like Dr. Mike. I think he’s adorable, humble and truly wants to make a difference in the world. (Nice character idea for a story, actually).
I think I like him largely because I can understand a lot of what he’s saying when it comes to medicine. Not on a doctor level, of course, I’m not a doctor, but from a medical professional standpoint where I’m asked to interview and prime patients to be seen by the doctor.
A LARGE part of what I do is interpreting patient body language and picking up on what patients are NOT saying. For example: “Oh, I see you’re taking Eliquis, Ms. Smith. Do you have a heart issue? History of blood clots?”
(Eliquis is a blood thinner).
Or a patient will say in an off hand way, “I fell about two weeks ago and it’s been hurting ever since.”
“Oh? What caused the fall? Did you trip on something? Did your legs collapse beneath you?”
Which might indicate dizziness and weakness.
Or a patient will endlessly squirm in his/her seat or the patient is pale and sweating, (low blood sugar?), or their hands are shake uncontrollably (Parkinson’s?)
Or his/her blood pressure is super high or super low which could indicate various issues (which you tell your doctor about so he is aware that is a potential problem if we get to the surgery stage).
And you can nearly always tell the patients who are sugar coating their pain and symptoms because they either want drugs or they plan on filing for disability. Sorry folks, but it’s a real thing and happens daily.
“What is your pain rate today on a scale 1 to 10, 10 being the worse?”
“Oh a 10, for sure,” the patient will reply and yet they appear comfortable and his/her blood pressure is normal.
Your blood pressure don’t lie, ya’ll. If your pain is at a 10, then you’re being mauled by a bear and being torn limb from limb. A level 10 pain rate is you’ve been in a horrible accident and had your arm ripped off your body. THAT’S a 10 and if your pain was truly at a 10, I can promise you, your blood pressure would be higher than normal.
But I digress. (Also, be honest on the pain rate when your health care professional asks you, people. Telling your doctor you have a pain rate of 10 because you want to make sure your doctor knows you’re in pain does NOT impress anyone, believe me. In fact, it might actually have the opposite effect, now your doctor can’t trust you to be honest with him).
The point of this post is the importance of communicating effectively. Not just for me when I interview a patient or for a patient when he/she speaks to the doctor, but with people in general. We talk about this a lot at work and I firmly believe that to be successful at your job, in relationships or life in general, learning to communicate effectively is KEY.
I don’t feel like a lot of people know how to communicate. I’m not claiming to be an expert in this field but I did learn a lot from my communication classes in college about the importance of facial expressions, body language and how NOT to speak to someone and instantly put him/her on the defensive because when that happens? Communication ceases to exist. Then it just becomes damage control.
Side note: When Dr. Mike is telling his story and he’s offering possible treatment options and the patient just flat out says no to everything he says, that is incredibly frustrating to not just the doctor but his staff trying to help the patient. If you don’t try this stuff, how do you know it won’t work? Also, I think society, as a whole, expects a quick fix to every problem. We live in an instant gratification world now with online shopping, instant pictures, super-fast communication options, etc., that people tend to forget. Sometimes, there isn’t a quick fix, sometimes, to solve a problem, it means making lifestyle changes, like stop smoking, start moving more, make better food choices, and people don’t want to hear it. This is not a realistic expectation and yet, it’s more and more common to encounter patients who get upset because we’re not offering a magic potion or a pill that will solve their problem in an instant without asking them to make any changes in their lives or require any effort on their end.
This is a HUGE problem.
And the part where he talks about her unloading on him about her personal issues HAPPENS DAILY. I can assure you that when that happens, most healthcare professionals want nothing to do with it. If it doesn’t have anything to do with the physical ailment you’re there to address, your doctor doesn’t give a crap. It’s not that he’s not a caring person, but he’s there to do a job and that’s what he wants to do, to help you with your ailment. And, let’s not forget the roomful of other patients that are waiting on him to fix their ailments. And though you want nothing more than to interrupt the patient and get him/her back on track, you can’t. One, it’s rude. Two, sometimes it’s helpful for the patient to purge those emotions leaving them free to focus on the physical ailment. Three, if you piss the patient off, then he/she is not thinking about the ailment anymore but focused on their FEELINGS in the moment.
It’s a fine line, and takes a lot of practice, to gently guide the conversation back to the ailment because let’s be honest, it’s not all about you. I have a doctor waiting on me to finish so he can go in and speak to the patient. And I have a waiting room full of patients fixated on the clock and OH MY GOSH, IT’S NOW FIVE MINUTES PAST MY APPOINTMENT TIME, WHAT’S THE HOLD UP?!
I have been known to look at people who bitch about the amount of time they’ve had to wait and say, “You know. You’re not getting your car washed. People are complicated and some take more time than others.”
In other words, don’t fuck with me. It’s called my “professionally firm voice.” Don’t make me use it.
And yet, those are THE VERY people who won’t shut up and talk about everything BUT the reason they’re there and taking time away from the other patients in the waiting room.
But back to effectively communicating …
- Rapport First – absolutely agree with this tactic. I make it a goal to speak to the patient as a person first. Ask them about their day. What are they going to do after their appointment. Make a self-depreciating joke and get them laughing. Something to help them relax a bit and feel human before we go poking at their sore spots. It doesn’t take long and it’s 30 seconds of time well spent.
- Epistemology – understand where the patient’s knowledge came from. Now, I’m not the doctor and a lot of medical stuff goes over my head, but when they say something about Googling their systems or they read something somewhere, I like to remind patients that though knowledge is good, you have to take what you read with a grain of salt. Reviews on Google are generally written by people who had unrealistic expectations to begin with and didn’t get their way or were pissed because they didn’t feel like the doctor cared enough about their ailment. And that may be true, but remember, there is always, ALWAYS, two sides to a story. It’s important to remind patients of that fact, at times.
- Don’t bully someone into a conversation he/she doesn’t want to have. This happens ALL THE TIME. I don’t know how this impacts the doctor and his conversations and maybe it doesn’t happen as often to the doctor because people know he’s the expert and they don’t want to piss him off so he doesn’t help them, but it happens to me and the nurse nearly every conversation we have. People in general, try to manipulate us in various ways to do what they want us to do. When I first started in healthcare, I used to cower and placate because I didn’t want to upset the patient and though I don’t go out of my way to upset patients now, I have learned how NOT to be bullied into something. I give patients controlled options. We can either do this or this, you choose. By approaching a problem this way, it gives the patient a bit of the control back. They may not like my options but if you want to move forward with my doctor and our clinic, these are your only options. I have no problem compromising with patients on something I have some control over, but ultimately, this is how it works. The process may be convoluted and frustrating, but it’s a process that works and that’s what we’re going to do. You are not the only patient we take care of and I wish more people would remember that. We’re in this together. I do not exist simply to take care of you and your problem.
There are times it’s better to shut up and listen, to offer sympathy, to offer options or to take charge of the situation. But the challenge is knowing when to apply these options because people are not cookie cutter cut outs. They are complicated and come from all walks of life and all sorts of experiences and often it’s prudent to stop and take your cues from the patients to effectively communicate with them.
I write all of this work-related stuff because I truly want people to understand where the medical profession is coming from when taking care of patients. I think too many people have too many preconceived notions about doctors and staff and it frustrates me to no end. WE are people too and we truly just want to do the best jobs we can do for both the patients and the doctors we represent.
Please remember that.