I understand you!
~Dr Prakrut Paidisetty,
MBBS.
“Half the disease is cured when you listen to the patient!”. This is a bit of wisdom passed down through generations of doctors. Of course, it was important in the past when you had only communication to rely on to make a proper working diagnosis and only a handful of drugs in addition to your confidence to manage a situation. However, with advancements in technology and growing collective knowledge in the medical fraternity, the importance of effective communication is downplayed. With a million things to keep in mind for good patient care, we often forget that the patient is a person and not a broken machine. This worrying lack of effective communication skills is particularly predominant in developing countries such as ours and understandably so, because of the high patient load.
Simple communication tools can take an appointment from the scariest day of a patient’s life to moderately acceptable. It all starts with actively listening and being genuinely interested to hear what the person has to say. Simple phrases of acknowledgment like, “I am sorry to hear that”, and “I understand your concern” give a signal that you acknowledge the patient’s problem, and that the patient has your full attention. Once you have acknowledged the patient’s concern, validation is the next step. Validation doesn’t mean accepting blindly what the patient has to say but making an active effort through your words and expression to make the patient comfortable. This much is enough to garner trust, as the patient doesn’t even expect this much in our current system.
But theory is bland, any concept can be better explained with an example. I would like to cite a real-life situation of great personal significance to tell you how effective communication can help someone achieve the impossible. Someone close to me needed an MRI urgently. However, due to a poor experience very long ago, he was too scared to go for it as the MRI machine is very loud the experience inside can be traumatizing, to say the least. For over 30 years no man, woman, or doctor could convince him to go for an MRI, even if his life depended on it. This time was no different. Me being qualified as a doctor and because I was so close to him, I was tasked with the duty to convince him.
Before I started counselling, I made it a point that he and I were alone. I started by saying I understood that he was scared, and I was sure he had a valid reason for refusing to undergo the investigation. There was a change in his expression, a sigh of relief maybe. I followed up by asking why he was so scared in the first place. He then opened up and said, that 30 years ago he had entered an MRI machine, and being somewhat claustrophobic he could not tolerate staying in the machine. He remembered that the MRI machine closes from all sides, and it is as if you are locked in a tiny cell. I could see from his tone and expression that it was indeed traumatic for him. However, the new MRI machines do not close from the front and back anymore, and he was not privy to this information. Understanding his thought process, I too lowered my tone and informed him of this new development. He wasn’t convinced! But he wasn’t disregarding what I had to say either. I then told him the benefits of having the MRI in terms of how it would help reach a proper diagnosis. He still wasn’t convinced. The next step was to intimidate. I stated rather sternly that not having the MRI would only lead to a delay in the diagnosis and the agony he is in would only continue. This seemed to hit a nerve. He began to understand the intensity of the situation and that the MRI was in his best interests. The best way to convince someone totally when they are partially convinced is to look for agreement! And that’s what I did. I asked him if what I am saying makes sense. He said “yes”, and checkmate! This is how a two-minute conversation was enough for a man to let go of his fear of thirty years. All because the person counseling gave him his full attention.
It only takes so much. Treat your patient like a person and not a burden. It opens an entire avenue of effective healthcare! This might seem like a small incident, but as a medical professional in my foundation years, small victories like this remind me why I chose this noble field in the first place. Healthcare workers want to help people, and communicating the same effectively goes a long way, and that is totally worth it!
References:
1. Price H [Internet]. [cited 2023 Nov 10]. Available from: https://blog.jostle.me/customerresources/3-actionable-communication-tips
2. [Internet]. [cited 2023 Nov 10]. Available from: https://nightingale.edu/blog/therapeutic-communication.html
