22 Jun Doctor Patient Relationship: A Relationship That Lasts
By Dr. Sandra L. Argenio, MD
Imagine the important relationships in your life. They are deep, lasting, full of emotional support in tough times.
As a family physician for over 30 years, the bonds that were formed with patients and families were lasting when these aspects were achieved. These bonds lasted years to decades. They were important to the patients. They were also important and sustaining to me as their physician.
The doctor patient relationship is no different. But sometimes patients leave their doctors. A recent article noted that some patients will have as many as 18 doctors in their lifetime. Why does this happen? Are there skills we as physicians can develop to lessen the chance of a patient leaving our care? The answer is a definite yes.
Healthcare is an intensely human interaction. We can learn skills to enhance this interaction and create a lasting relationship of continuity and trust.
First, we must be present – not just physically, but totally – with our full attention. If we are truly present, the interaction becomes the most important thing in the world to us. No distractions. No interruptions. Just us and the patient in front of us. For many people, this type of presence is such a unique experience that they will sense the difference in the conversation. It is about them – truly and uniquely.
Once we are truly present, we can begin to listen to understand the story that is being told. Listen with attention and curiosity, without judgement – an empty vessel waiting to be filled with the words of the person speaking. What a surprise for them! No interruptions, no detours, just the story they want to tell. What a surprise for us! A story that flows – we don’t have to anticipate the next line or plan our response. Just let the other human being tell their uniquely human story. Hopefully, truthfully, with trust, heart to heart.
It may sound like too much – too good to be true. Can being present and listening really make a difference in the story that is told? In the information that we gather? In the healthcare that is delivered? In the safety to the patient? In the ultimate outcome?
Such a simple step. Could this possibly keep a patient in our care even when the going gets tough?
Take a look at these actual patient comments:
“Doc – no one has ever listened to me like this ”
“Doc – thanks for listening”
“I was afraid to tell you about this – thank you for listening”
And there it is – the patient’s real story. The one they tried to tell us. Or maybe the one they were afraid to tell us – or anyone. Their pain, their shortness of breath, the symptom they almost didn’t tell us due to fear of what it might mean, what it might lead to in terms of tests, costs, time off work or away from their family. The very symptoms we need to know to make the correct diagnosis and treatment plan.
The Institute for Healthcare Excellence (IHE), recognizing the foundational role that effective patient-centered and compassionate communication has in creating a culture of safety, enhancing outcomes, creating an excellent patient and family experience, and achieving efficiency, has developed a skills based curriculum that has resulted in significant measurable improvement in compassionate communication, teamwork, mutual respect, and safety/outcomes metrics. The skills of being present and truly listening form the basis of The IHE’s communication curriculum.
So, give these skills a try. Take a deep breath, put other thoughts aside, pay real attention to the patient in front of you.
Listen- really listen. It might surprise you – and your patient! Two humans – one intensely human interaction. A relationship that lasts.