Doctors are not trained to communicate with patients. Now, with the onset of electronic medical records this problem has become worse. Many of them hardly even look their patient in the eyes; instead their faces are often buried in the computer screen and not on us.
Since they don’t really know us, they stumble around, often awkwardly, unable to give us the difficult information we need to know and then run out of the examining room. Not knowing who we are means that they can not help us make decisions, they can not support us in our tough often life and death decisions about what drugs, treatments and settings we want to use in our fight. To often they don’t know what we want and what is important to us, especially as we approach the end of our life.
Many doctors struggle to tell us we have some serious disease, like advanced prostate cancer. They are also uncomfortable and simply terrible at talking to us about our death, which simply is the ultimate result of life.
A good doctor gets to know and understand the thoughts, desires and life concerns of their patients. As hard as this might be there are some simple ways that would help a doctor overcome their barriers, their fears and let them get to know their patients.
Good doctor to patient communication can be very successful with a doctor asking four simple questions and then allowing the conversation to go as it develops:
1- What is your understanding of your health or condition?
2- What would be your goals if your health worsens?
3- What are your fears?
4- What are the trade-offs you would be willing to make and not willing to make?
Repeating these questions, actually conversations, again and again will, over time allow your or doctors to really get to know our wishes and desires. Each interview will yield different answers because the answers to these questions will change for us as our needs change, our concerns change and our disease progresses. These conversations will allow a doctor to get to know how you think and what is important to you. Knowledge like this will allow a doctor to respect and support you and your priorities.
Joel T. Nowak, M.A., M.S.W.