Doctor-Patient Communication

Early in my blogging, I wrote a post for residents about how to speak to doctors, outlining what I call the Newspaper Headline Approach.  It’s designed for residents to make the most of their interactions with their physicians.  I was reminded of the Newspaper Headline approach when I read a recent Mind the Gap post by Stephen Wilkins, MPH titled Why It’s So Important For Physicians To Listen – The Patient’s Perspective.  How to talk and why to listen — a great combo.

Dr. El’s Newspaper Headline Approach

Talking to a medical doctor is not like talking to a normal person.  In a regular conversation, one person says, “Hi.  How are you?”  The other says, “Fine.  And yourself?” And they go from there.  If busy Dr. Shah stops by Mrs. Crenshaw’s room, inquires how she is, and hears that she’s “Fine,” he’s likely to be on to the next room before Mrs. Crenshaw can utter another word.  Instead, I suggest the Newspaper Headline Approach.

Newspapers grab the attention of readers by revealing the most important and tantalizing details first, so we’re compelled to read on. The same approach, applied to a visit from a physician, would sound like this:

Dr. Shah:  ”Hi.  How are you, Mrs. Crenshaw?”

Mrs. Crenshaw’s headline:  ”I Have Pain.”

Now she has Dr. Shah’s attention and he will almost certainly ask her where she has pain and other follow-up questions.

Another possible headline:  ”I Have Two Things I Want to Discuss with You.”

This indicates to Dr. Shah that he’s going to need to stick around after the first issue is complete, and it helps him estimate how much time he can spend on each matter.  With the Newspaper Headline Approach, the most important problem is revealed first.  This way, if Dr. Shah has to leave, at least Mrs. Crenshaw had her most pressing concern addressed, and her doctor is aware there is more to be discussed.

Perhaps this sounds simple, but it’s surprisingly difficult not to answer the question, “How are you?” with the response, “Fine,” even when we’re not.  It takes practice to resist the temptation and to tell the physician from the start what’s really going on.


Why It’s So Important For Physicians To Listen – The Patient’s Perspective

by Stephen Wilkins, MPH at Mind the Gap

A recent qualitative study (structured interviews) of patients conducted at McGill University School of Medicine underscores the importance of listening in physician-patient interactions.  In this study, patients were asked to identify the qualities of a good physician.  The following is a typical patient response:

“A good physician is somebody who will listen to what the problem is and explain to you what it is and what is being done.’’

When people were asked why listening by the physician was so important, researchers discovered three important themes that have apply to every provider today.

Theme #1 – Respondents (people/patients) believed that listening was essential if the physician was to arrive at the right (and credible) diagnosis. 

Representative Comments:

  • ‘Physicians “should trust the person in front of them and hear what they’re saying. . .because I know my body better than anybody else.“
  • ‘‘Listen to what they [patients] have to say; not just what other people wrote about them in the doctor’s notes.
  • ‘‘[If] I feel that I haven’t had enough time with you to tell you exactly what my story is, even when you give me a prescription I’m going to say, ‘Really? Is this prescription right for me and for my illness? Or [is it] going to give me more complications?’. . .and I think sometimes that’s why you find patients will take it for 1–2 days and after that they forget about it, because they say, ‘He didn’t hear what I had to say about this pain.

Visit Mind the Gap to read the whole post, which discusses all three important themes and the take-aways from the research.

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