Transcriber: Luis Santos Reviewer: Hani Eldalees
You see, I was recovering from an injury.
Not long ago, I hurt my shoulder, And I nursed it for a few weeks
But I realised, I had to go see the doctor and do something about it.
I’d love going to see the doctor, because I’m a doctor myself.
And I love to see my colleagues in action.
I almost always get something out of visiting other doctors when I go
for my own issues. So I called up and got an appointment with Dr.Greg,
my primary care physician.
And I was sitting in the cold plastic chair, in the even colder exam room when I
heard that familiar knock at the door.
I perked up when he came in and immediately I could see he had
a scowl on his face. Dr. Greg seemed rushed.
He was fumbling with his laptop computer.
He quipped hello directly to the floor, never making eye contact with me, u-oh,
this wasn't going well.
He started looking in the computer
Well, you need a refill of your medication and I’ll get you a referral
for physical therapy, OK? My heart sank.
I felt like, wait a minute,
what I really wanted to talk about were my sleep issues that were related to
my shoulder pain, but I felt remiss to interrupt Dr. Greg.
He seemed like he was awfully busy.
The visit ended unceremoniously and I made my way to the checkout area.
Her father of medicine, Hipocrates,
said that relationships between clinicians
and patients are incredibly important and they can affect overall health.
Thousands of years later, we performed mechanistic research to prove that point,
yes, good relationships between patients
and clinicians can improve health outcomes.
If you feel good about the person taking care of you,
chances are you're going to follow their advice, maybe try that exercise program,
eat better, think more about heart health.
But the converse is also true.
When we don't feel good about the doctors taking care of us,
we tend to suffer. Think about the disruptive doctor,
the physician with the God complex. we all know him, and it’s usually a him.
He tends to be a very highly trained specialist.
He really knows his craft well. He rules the operating room.
He knows his way around the exam room.
But when it comes to listening,
when it comes to being attentive to his patient's needs,
he may not have the best bedside manner.
Sometimes he can be off putting, arrogant, he can upset us,
offend our sensibilities as a result,
we may not want to go back and see this person again,
and our health suffers as a result. So what do we do?
Why is it that we know good health is predicated on good relationships?
But yet sometimes we don't remember how to communicate well with our patients.
I've had the privilege of being a professor of medical students
for over 20 years. When I teach about the heart,
the classroom is completely full.
When we talk about setting bone fractures, it's standing room only.
But when I go to speak with my students about communication.
The room is suddenly half empty.
The medical students have scurried away and those that are in
the classroom look at me with half an eye
and are looking at their smartphones with their other eye,
presumably at their Instagram account or something.
So... why is it that we recognize good health comes from good relationships
and good relationships are predicated on good communication? And yet,
we don’t attend communication classes. This may stem from an
Inflated sense of ourselves,
we may think we're better communicators than we actually are.
Turns out this has been studied too.
A number of orthopedic surgeons were looked at in terms of their
abilities, 75% self rated their communication as very good or excellent.
Seventy five percent. Then
the researchers looked at those same doctors patients.
And the patients rated their doctors communication very good
or excellent 21 percent of the time. That's a huge gap.
So maybe there are other forces at play,
maybe this has something to do with communications training or lack thereof.
Or maybe the problem stems from a lack of humility. Now, I get it,
being humble is sometimes associated with a bad rep.
We think of being humble as not being strong, as not taking charge,as being weak
But it turns out that humility might be a good thing.
That actually, looking at the definition of humility in
the Merriam Webster Dictionary tells us that humility is freedom from pride
or arrogance.
Why is it that so many of our leaders lack humility?
Why are so many of our doctors arrogant?
Maybe it's because humility can seem soft at a time when problems are hard.
Maybe being humble, not knowing all the answers might somehow give patients
a sense that we don't know what we're doing.
In fact, I’ve seen a number of younger physicians taking over-confident stance.
To, say, mask their ignorance or uncertainty,
and I've seen older physicians do it as well,
but I think it takes a strong clinician to recognize when they don't know all
the answers and to engage with their patients
on maybe I'm not sure what's going on,
but let's see if we can figure it out together.
If we can stop talking and just listen to what our patients have to say,
generally speaking, we're going to figure out the answer.
Listening is an art form. It takes patience,
authenticity and some self regulation.
But listening and communications are also skills that can be taught,
taught just like, say, teaching folks how to listen with a stethoscope to
the heart or to suture up a leg.
Communication skills can be taught,
but folks need to attend classes to learn how to do it.
If we're not humble, sometimes our patients.
Might not want to follow up with us.
They might feel that we're off putting, that we're too directive and as a result,
we tend to label these patients that don't follow our directions
as non-compliant, as lost to follow-up.
Sometimes we say that our patients have failed us when in fact it's
the other way around, we have failed our patients.
The early 20th century physician Francis Peabody once said that
the secret to caring for the patient is to care for the patient.
Today, it can seem awfully chaotic in the practice of medicine.
We have so many patients to see, we have to fill out billing forms,
insurance forms, we have to document everything in these little tiny computers.
But if we humble ourselves to our patients,
if we stop and really listen to what's going on, that in and of itself.
Can be therapeutic for the people we're taking care of.
We just have to put away the computer,
fold up our stethoscopes, and just take an active listening stance.
Humility can sometimes feel soft, but in fact, I think humility is strong,
it helps us to become better listeners, better communicators,
to form more alliance with the people who are suffering.
Humility can help us support our patients needs,
their fears. Humility can help us support them. Thank you.