Do you feel heard after leaving your doctor’s office? Do you feel you understand what the doctor said to you?
Surveys suggest doctors and patients often fail to communicate effectively, so public and private medical organizations have implemented programs to improve “patient engagement”. But what exactly does that mean?
A failure to communicate
Patients may feel that doctors ignore their questions, dismiss their concerns, don’t listen to them,don’t spend enough time with them, and don’t use language they can understand.
Physicians wonder why patients withhold important health information, fail to follow up with recommendations, and don’t ask questions or express their concerns.
The main problem with health care communication is that it involves people- and people frequently communicate poorly, and sometimes not at all. It never will be perfect. But we can do better.
So what is true patient engagement anyway?
Dr. Rob Lamberts writes
“Engagement is about interaction, listening, and learning in relationship to another person.”
Barbara Ficarra, R.N. , puts it this way:
“Patient engagement is a connection between patient, caregiver and health care provider.
Patients and their families are empowered and they are active in health care decisions.
Those patients and consumers who choose to be actively involved and in charge of their health work together with their health care providers to successfully rech their health goals and needs. “
Why communicate better?
To make healthcare interactions more effective, efficient, and empowering, both doctors and patients need to develop skills that may be different from what they have done in the past.
Communication is a connection allowing access between persons
Establishing a connection
If we try to start exchanging information, or even thoughts and feelings before we have established a connection, it is like to be unsatisfactory.
For example- think about a recent retail service experience – one that worked and one that didn’t. Perhaps it was a call to customer service to get a phone service problem resolved. Or maybe you went to a car dealership and interacted with a sales person. Whatever the situation, and whatever the outcome, you probably rated it more favorably if you felt connected with the person helping you.
Recently I called my medical insurance carrier to resolve some unpaid claims- and my insurance is through a government agency. I dreaded the call, expecting a difficult unpleasant conversation.
But the rep was professional, efficient and confident. She started immediately by telling me her name and position, then asked me my name. Next, she accessed and reviewed my account, giving me feedback about what she found. Then we started working on my problem, and continued until it was resolved.
I was surprised to have the situation taken care of efficiently and effectively so quickly. And in doing so, I felt empowered.
In dealing with others be willing to be frank , flexible, and forgiving.
The who of connection
Customer service depends on connecting, and that usually starts with knowing who you are dealing with. The first item we exchange in any human interaction is usually our name.
You should learn your doctor’s name and credentials-M.D., D.O., and specialty- internal medicine, cardiology, psychiatry, etc. in other words, what kind of doctor are they?
What is this doctor’s role in your care? Is this doctor primary or a consultant, and what issues are each managing? (especially in a hospital situation)
Tell your doctor what name you prefer to be called if it’s different than the name on file. Your doctor should know who is your legal next of kin or who has POA (power of attorney if applicable)
Introduce other family and friends and identify the primary contact person; this first level of receiving and giving information, is especially important in the hospital setting. This will create continuity as the doctor speaks to the same person every day.
If you take a friend or relative to your doctor’s office with you, make sure they understand what their role is. Your family’s insights and observations provide helpful information to supplement what your doctor learns from you. They can help you remember and understand answers and instructions. But this isn’t a time for them to discuss their own medical issues with the doctor.
The where of connection
Where you interact with your doctor is important as interaction may be quite different in a private office setting vs an urgent care clinic vs an emergency room vs in a hospital. But general principles apply to all settings.
Approaching others with generosity, grace, and gratitude makes it easier to connect.
Ideally it should be as comfortable as possible, private, and quiet, so you can hear and see each other well.
Friendly greetings are fine anytime you encounter your doctor, but discussions of personal medical information don’t belong in the hallway, elevator, or cafeteria. Likewise, if you run into your doctor at church or the grocery, just say hello.
The how of connection
Come to an office visit prepared. If you have test results, previous medical records, xrays, etc. bring them with you.
An up-to-date list of all medications you take is a must-include names, strength, how often taken; or bring the meds with you.
Turn off your phone.
Ask the office how long the appointment is for, realizing that it will only be an estimate; it will depend on what you and the doctor end up discussing and what you need done.
Showing up on time helps the office keep to their schedule and shows the doctor you are serious about your care and respectful of other patients’ time. (If the office is consistently poor at time management, address it respectfully; sometimes it is best to move on if this continues to be an issue that bothers you.)
Most hospitals and clinics have abandoned paper charts for computers, using electronic health or medical records- EHRs or EMRs. I’m not going to dwell on it now, but computer use in the exam room or bedside has changed the dynamic between doctors and patients in ways that were unexpected and challenging. Here is the link to a post I did addressing the issue of
Electronic Health Records- Challenges and Changes
The value of connection
Connecting with your physician depends on acknowledging feelings- worry, fear, despair, hope, relief, anger, resentment, frustration. Give feedback respectfully; if anything about your care is not as expected, or doesn’t seem appropriate, or you just don’t understand something, speak up.
Expressing feelings honestly and respectfully, and listening with empathy and respect can build the trust that is vital to creating a connection for effective information exchange – communication.
Dr. Jonathan Weinkle discusses connection and relationships in his book
HEALING PEOPLE NOT PATIENTS: Creating Authentic Relationships in Modern Healthcare
which I reviewed at this link.
exploring the HEART of communication
You can connect with me on social media using the links in the sidebar.
Dr. Aletha
3 keys to effective communication with your doctor, part 2
updated October 31, 2022 In part 1, we considered the importance of establishing a connection between doctors and patients before trying to communicate. The goal is to establish effective patient engagement. Now we’re going to look at some practical aspects of exchanging information with doctors- remember, exchange means give something and receive something in return. A…
Keep readingUse these links to share the heart of health wherever you connect.
watercress words by Dr Aletha 
I was just this morning telling a friend about a former doctor of mine who is a former doctor of mine because he told me right to my face that he hated it when his patients had opinions. That was a long time ago.
This year I’ve got the absolute flip side of that story – I’ve been going through a health issue of a level I’ve never dealt with before (breast cancer), I’m being cared for at NYU Langone, and I don’t know what kind of training the folks there go through but everybody – doctors, nurses, receptionists, security folks at the front desk, everybody – has been so amazing about being open and clear in what they’ve been telling me. The breaking of the diagnosis was especially good – of course the doctor had to start with the bad news – “Yes, it’s cancer” – but then before I had time to even start freaking out, she gave me all the reasons I didn’t need to freak out. Then she was ready for questions. Really amazing job. All’s going so well that I’ve been telling friends that this has been more of a hassle than an ordeal (which is really excellent), and I think the good communications by the team who’s been caring for me and their support staff has been a big part of why that’s so. Good stuff, yeah?
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What a success story! Wow, I am so pleased that you have had such a satisfactory experience so far. Thank you for sharing this; it’s one thing to say we should communicate better, quite another to see it in action. And I pray you continue to do well in all aspects of your treatment.
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Very interesting hearing about this issue from the doctor’s perspective. I’ve learned the hard way that I need to write down the things I want to talk about. Otherwise I’ll remember right as I’m walking out the door – so frustrating!
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Yes, that’s why doctors keep records; we could never remember everything about every patient either.
If your doctor’s office uses an electronic record system, there may be an option to communicate by email, then you automatically have a written record. Email shouldn’t be used for complicated or lengthy discussions, but for a quick follow up question it’s a good option. I hope you have this available now or soon.
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and harder to communicate with one’s doctor when the doctor wants to put the patient (me) on prescription drugs – and the patient (me) is trying to get the doctor to understand that i don’t do it that way
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It is important for doctors to offer what they think is the best approach to a patient’s problem and for the patient to listen and consider before making an informed choice . And that may change at each encounter. If there is a trusting relationship, they can negotiate the most effective and acceptable option for each situation. In your case, I wonder if this is a new doctor, or someone you see often? And did you feel pressured to accept a prescription you did not want, or did the doctor and you discuss your preference for a different option ? You and your doctor probably won’t always agree on everything, but that doesn’t mean you can’t connect and communicate meaningfully.If you don’t have a doctor you feel comfortable with, I recommend you find one soon.
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I have had doctors where I felt like they didn’t care about what I had to say, and then I have had doctors who truly listen and want to understand me, not move me along. I definitely prefer that latter, and this is a great post to raise awareness of this vital relationship.
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The medical school I attended now uses “simulated patients”, people who are trained to act as patients to help students learn how to interact with empathy and caring. Other schools do it too. This should help to produce more of the latter and fewer of the former. Thanks for sharing .
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I love the quote that engagement is about interaction, listening, and learning. That sums it up nicely. Such great tips for communication for your doctor and other relationships too.
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Thank you I appreciate the helpful feedback
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Communication can be problem. Sometimes I feel silly asking about certain things. It’s hard to know what is important to mention and what is not sometimes.
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That’s understandable. I’m going to address this in part 2 next week. You may also find a previous post helpful- “How to tell your doctor what’s wrong with you.” Thanks for the feedback.
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Hi Aletha, this is awesome on many levels. It is a topic rarely spoken about. I am so thrilled reading your thoughtful advice. Thank you for sharing.
God Bless, friend
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Thank you for responding. I’m glad to hear that it’s helpful.
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This is a great post. It is so important to be a good communicator in any situation but communicating with your doctors is so important. Thanks for sharing your insight.
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You’re welcome and thanks.
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“I propose there are three keys to effective communication; realizing there is no one right way, no one size fits all. Each person and situation is unique, with different personalities, and styles of relating. Some or all of what I suggest may not be appropriate or work in some situations.” what a wonderful word of wisdom that can be applied to every aspect of life.
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Thank you.
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This was interesting. I’m fortunate to have a wonderful GP.
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I’m glad to know that. I hope you have told your doctor also. Thanks for visiting.
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These are great tips. I am blessed with a great team of doctors, and they are good at actually communicating, not just about my physical health but my emotional health.
Marissa
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Sounds like they know how to use empathy and respect to create trust. You are blessed indeed. I hope you have expressed your appreciation to them.
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Interesting read, and lots of wisdom that can be applied to lots of situations. I particularly liked this “In dealing with others be willing to be frank , flexible and forgiving.
Approaching others with generosity, grace and gratitude makes it easier to connect.”
Good words!
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Thank you. Basically “do unto others.” It applies in medicine also.
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I really like my PCM. He does a great job of connecting, but the practice forces him to schedule too many PPD, and he is always running late, but I will say that when he walks into the room, he gives me 100% of his attention. He uses a laptop next to me so that is isn’t between us, and he is more looking at me than it or turns it so we are both looking at it. I will be sad to change practices when my husband has to relocate.
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Thank you , I’m glad to hear about a satisfied patient and a doctor who gets it. I hope you will let him know how much you appreciate his care; we tend to hear more from the disgruntled patients than the satisfied ones. I bet hearing or reading a compliment from you would make his day.
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Good idea! I am actually seeing him tomorrow. I’ll take him a Christmas card!
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You’re welcome and thanks for visiting and commenting. I’m glad you found it helpful. We are all busy and it’s tempting to just come in and get the job done. But it is a more pleasant and ultimately productive process if we take the extra time to get deeper. As the patient you can benefit from the physician’s expertise, knowledge and experience so you might as well make the most of the visit.
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It was really interesting to read this from the doctor’s perspective – often we rush in to an appointment and don’t think about how we communicate and how much we can gain from an effective interaction. thanks so much for sharing on our #OTM link up 🙂 ~ Leanne
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