Does Your Doctor Talk to You? Talking Is Half The Care.
I was attending to patients when this young lady came in with the result of her test. She had all the infections you could think of. Another doctor would have simply written her a prescription but I asked why she had all the sexually transmitted infections. For what seemed like five minutes, she didn’t respond. I had a long queue of patients waiting to see me but something told me to stick it out with her. I asked her if she had a boyfriend and she responded in the affirmative.
“Then why don’t you use protection?” I asked her. She didn’t respond again for another five minutes.
It happened that she was dating this guy who rapes her and then when she gets pregnant, he takes her to a shabby place to get an abortion.
“Then why do you keep going back?”
She said with no willpower, “I love him.”
That was the conversation between Dr. Opeyemi Emoruwa and a patient explaining how having a conversation with a patient helped him provide better care for the patient. Had he not asked and probed the young woman further, he would have just been treating a symptom of something deeper that would keep recurring.
If you’ve been to the hospital lately, you know most doctors don’t have the time, energy or patience required to actually talk to their patients. They attend to too many people within the time frame they are given, they are burnt out from overstretching and they simply can’t afford to ask too many questions that might not be useful at the end of the consultation.
However, according to Jeniffer Fong-Ha and Nancy Longnecker, “effective doctor-patient communication is a central clinical function in building a therapeutic doctor-patient relationship, which is the heart and art of medicine. This is important in the delivery of high-quality health care.”
Basically, conversations are at the heart of a satisfying doctor-patient relationship. When a doctor shows that they care about your well-being, are willing to listen to you without judging you, and make you feel comfortable to share, patients are more likely to open up fully about their conditions and symptoms that will help the doctor better provide care.
Experiencing one of my bouts of cold and cough again, I walked into the hospital ready to see a doctor so he can examine me. After waiting for hours on a long queue, it was my turn. Going to the hospital these days is just some necessity I have to do to get relief from whatever condition took me there.
He looked at my file and looks up at me “wow! You are so young and you are a member of staff”
I smiled and took the compliment, “yes I am.”
“And you work at the radio station” he continued.
I usually love it when people notice tiny details about me like that and I even like it better when a doctor that is about to attend to me shows some interest and tries to get more insight into my condition by asking me questions. Several times, when I visit the hospital and the haste with which the doctor attends to me, without asking more questions for clarity makes me question their competence.
From that first time I encountered Dr. Opeyemi Emoruwa, I have gone on to have multiple encounters with him, either at his place of work where I am a patient or at my place of work where he is my guest.
In this conversation with Dr. Emoruwa, he talks about how having conversations with his patients have helped him help his patients better.
“Medicine is an art whose magic and creative ability have long been recognized as residing in the interpersonal aspects of patient-physician relationship.”
According to Doctor-Patient Communication Review “the core clinical skills a doctor must have are communication and interpersonal skills that include the ability to gather information in order to facilitate accurate diagnosis, counsel appropriately, give therapeutic instructions and establish caring relationships with patients.”
Dr. Emoruwa explains how it started for him in his practice…
“How this thing started was that when I was in school, I didn’t enjoy going to the ward or doing the practical aspect of medicine. Things like taking a sample from a patient, putting an IV line to give them fluids, how to do the PCV, how to set up the machine, and all. Those times, those things looked very big and people that were serious were always forward, as student, I used to watch that and think like is it fair that these people are using other people to learn but the place is a teaching hospital and it is assumed that when you are going there, you know in your heart that people are going to learn with you in a supervised way. So I was always avoiding those procedures and examinations that are very invasive like rectal examination. But you need to know those things because when you become a doctor, you’ll have to attend to patients.
When I now became a house officer, I didn’t have a lot of skills in the day to day things that you have to do for patients so when I want to take samples from patients, I want to be friendly with the person so that even if it appears as if I am not good, my niceness to the person is compensating for what I can’t do well. I remember one particular patient in my first month, for an adult to be crying while I was taking samples it had to be bad. But the thing about that place is that you are the one they just threw there so you have to do it. I kept trying and trying and the woman was crying. At the end of the day when things like that happen, I want to compensate with paying more attention to the person and that was my initial strategy.”
“The ultimate objective of any doctor-patient communication is to improve the patient’s health and medical care. Studies on doctor-patient communication have demonstrated patient discontent even when many doctors considered the communication adequate or even excellent” says Longnecker and Fong Ha. This might be a result of their confidence in their expertise. Medical professionals tend to forget that the person is a human being with emotions and even though they have explained the side effects of not following instructions to patients, they have not addressed the underlying cause of their concerns.
Dr. Emoruwa explains further, “I also discovered that the better I got at doing all those things, I didn’t want to focus on being nice again. And that’s the thing, you see a lot of people who have skills, they can do this surgery, they can do this procedure and then when they are dealing with patients, they are not paying attention to them. They are now confident in their skill because they believe they are the only ones who can solve the problem. I also noticed that people that I attended to when I didn’t have a lot of skills responded to me well, I was able to get more information on their condition or better context about some of their problems because they are telling me not just as a doctor but as someone they trust that has their best interest at heart. So it has gone beyond just seeing a doctor but seeing a doctor that cares about me. Then they start talking about their feelings but when you don’t listen to patients and all you want to do is your job, patients start feeling at some point like a thing or an object. Those were the little things I started noticing and I thought that if I was this person, how am I going to feel.”
Conversations are how you understand people and how you connect with them to help them solve their problems.
How have conversations helped you deliver better when it comes to your work?