And I'm off to N'Orleans tomorrow for the International Conference on Communication in Healthcare. Never been there before, glad I'm getting a chance to go before it's under the ocean.
I'll be presenting some of my research on physician-patient communication. Long story short, and probably not a news flash, but doctors still aren't doing a lot of the stuff they should be doing to help us understand and remember what's going on, and make decisions together that work for us.
The way a medical visit ought to go is first, set an agenda. What do you want to accomplish today? And here's what I want to accomplish. If it's too much, what is the priority and what can wait? Then go through it in an organized way. The doctor should ask open questions to invite the patient to express concerns or ask questions of her own. The doctor should explain that there are alternatives, not just say what he or she thinks is best without explaining why. Patients should have a chance to say why they might find it hard to follow advice. They should have a chance to state their own relevant values and goals. The doctor should ask the patient to repeat back, in his or her own words, any important information and instructions. ("Do you understand?" is a waste of oxygen.) And there should be a wrap-up at the end that reviews the important points.
Doesn't sound too hard! Also hardly ever happens. Doctor visits are a disorganized mess and doctors just tell people what to do. And people only remember half of it without prompting. Even with prompting, if there are too many things to remember, people remember fewer of them.
Have you ever been frustrated by a visit with a physician? Why?
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3 comments:
To be perfectly honest, I've never not been frustrated by a visit with a physician. I find them all to be abrupt, condescending, too quick to prescribe, uninterested in the nuance of the individual, preoccupied, and disengaged from the very personal aspect of the moment. It's even worse now when they stare at the computer screen instead of at good ol' flesh and blood me, sitting on the edge of that paper-covered vinyl examining table.
Enjoy New Orleans!
Yes, my doctor talks at me often on issues unconnected to my visit. During my last annual visit he took several calls from his kids. It went like this, ringgggg, ringggg, Hello Bobby, no you are not responsible for that today just water the lawn. Hangup and where were we? Ringggg, ringgg, hello Carol, no I just talked to Bobby, he doesn't need to cut the grass today. Where were we, oh yeah, eat walnuts every day and you'll lower your risk of heart disease by 25%. Quinoa is a good food, many of my patients can't afford it but I think you probably can.
I definitely need a new doctor, but I'm not sure it gets any better. I am waiting for my AI robo doctor. Please sign me up with R2D2.
Daniel, that is incredibly unprofessional. Docs need to take time for their families and be good parents, but their kids and spouses need to be instructed not to call them at work about trivia. Medical encounters are sufficiently disorganized and full of distraction as it is.
I would dump him if you don't feel comfortable talking with him about this; or if you do talk to him about it and he blows you off. He owes you an apology.
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