Many patients can be frustrated that their family member, friend or spouse can’t physically be at their side during office visits. This can generate a great deal of fear, confusion, frustration and often times anger. Rather than spending time defending, explaining and arguing with the patient, consider how we can help patients cope. This will begin with increasing our own self awareness. Before we can manage the emotions of others, we must first be able to manage ourselves. Recognize, what your default reaction is to the angry patient. Do you become a preacher, a prosecutor or a politician? Do you attempt to try and convince them of the need for the policy, condemn them for their reaction or placate their hostility by appealing to both sides. None of these reactions are going to be productive in the limited time you have in the office. Put your ego aside, recognize your default mode and view the interaction from a helping mindset. The patient’s negative emotions are arising from a threat to their needs, safety or values. Consider they may fear that they will receive bad news or painful things are going to happen. Often they fear that they won’t understand what is said. This is an opportunity to focus on ACTIVELY LISTENING to what the most important concerns/fears are for the visit. Second, this is an opportunity to ACKNOWLEDGE the concern of not having someone with them. Third, this may be an opportunity to help patients experience new autonomy and experience a sense of EMPOWERMENT in their care. Practically speaking, how can you do this? Consider the following steps to help demonstrate active listening , acknowledgement and empowerment.
1. Offer to call the family member/ friend/spouse during the visit or at the closure
of the visit
2. Print xays and offer to label with diagnosis/key anatomic landmarks.
Encourage they share with spouse or family member
3. Write down your diagnosis , recommended treatments /studies or medication
names in short summary for the patient
4. Ask the patient to recite back to you their understanding of the diagnosis and treatment plan/next steps.
This final step helps embed the learning from the visit and allows you to ensure everyone is on the same page. Some patients may even experience newly found empowerment through better understanding and control over their health. The COVID pandemic brought us many scary and unsettling changes in our daily life, but it also brought an opportunity for us to see things differently and grow under the stress of what is new and unknown. I like to end my visits with patients by sharing my business card and gratitude for their trust in me. On many of my business cards, I have hand written various inspirational quotes. The quotes are random, but often inspire me to see the small wisdom in the routine work we do every day. The following quote embodies the methods above.
Tell me and I’ll forget, Show me and I may remember. Involve me and I’ll understand—Chinese Proverb
Topics for exploration imbedded in this thought piece: Emotional intelligence, growth mindset, active listening.
To understand more about the "preacher, prosecutor and the politician" check out the book THINK AGAIN by Adam Grant.
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