Monday, February 07, 2022

by Suneel Dhand, Md

Suneel Dhand is a physician, author and speaker. He is the Founder at DocSpeak, and Co-founder at DocsDox. He blogs at his self-titled site: suneeldhand.com

The doctor-patient interaction is the absolute core of clinical medicine. Maybe I’ll go much further: it’s the core of health care in general. I always try to remember, whenever I’m ever feeling frustrated with the system, the crazy bureaucracy — and of course, the debacle of our clunky electronic medical records and their data entry requirements — to separate myself from all of that when I’m face-to-face with my patient and their family. This time is priceless, it’s why I went into this. The interactions and honor of serving my patients at a low point in their lives, makes it all worth it. It’s where the magic of medicine happens, and is something that is untouchable by any external factor, if you choose to make it that way.

Here are three things that patients want from that doctor-patient interaction:

1. A compassionate doctor who communicates well. A physician who understands that they are coming to them for help, shows empathy, and listens carefully to the problem. The doctor should exhibit both in their verbal and non-verbal communication, that they are fully engaged in being their doctor, who truly cares for them. There are an array of phrases and body language techniques that can be used to show empathy, all of them are very learnable, and deeply appreciated by your patients.

2. A doctor who is honest and transparent. I actually think almost all physicians are this way anyway — highly trustworthy professionals in the first place (anyone not that way, would unlikely have made it so far). Nothing but complete honesty with a sincere interest in getting the best possible outcome. Explain everything slowly, clearly and in understandable terms — as if you are talking to a family member who knows nothing about health care.

3. A non-distracted physician. Nobody wants to pour their heart out to somebody who is not fully present in the conversation. No turning around, clicking, or looking elsewhere for extended periods of time. This is patient face time, not screen time. A technique that I use, that gets very positive feedback: I actually ditch the computer completely, especially when meeting a patient for the first time. I sit opposite them, lean in, and am fully present. I jot notes down on a piece of paper on my lap. Patients love it (actually anyone would like that kind of service when they are explaining something in a professional situation, even at Home Depot!). Writing things down when face-to-face with someone, subconsciously gives a better impression that you are concentrating and mentally processing, rather than typing on a keyboard and turning at a screen. It just does.

So these are just three things that any physician should strive to do in their interaction, to give their patients the experience they deserve. It may just be another “name on the list” for us — but for patients who may have waited hours or days to see us, it’s the part of their day that they will usually remember and appreciate the most.

Over my years of treating thousands of patients, seeing so many misunderstandings and poor interactions, and now being in a position where I am teaching many of these skills — I am really of the belief that what patients ask for is really not that much. We are already very good with our scientific knowledge and have stellar treatments at our disposal — but it’s the human side that is too often forgotten. Sure, time is tough, and not available in abundance. But even just an extra minute or two can make a huge difference.

What I am saying here may not sound “trendy or fashionable” to lots of folks. Scroll the Twitter and LinkedIn feeds of many of our administrators and technologists, who are now dominating health care, and you’ll soon see why the above is the last thing they want to hear. To lots of them, health care is all about spreadsheets and numbers, expensive new technologies, and building factory-like processes. But it really isn’t, and never will be. Unfortunately too, the doctor-patient relationship is something that may even be intimidating to many administrators — because it’s something that they can’t “get to” or really control. It shouldn’t be that way.

We are currently in a health care swamp of epic proportions, where we lose the forest for the trees. We keep moving further away from the frontlines, among a tidal wave of bureaucracy (see this chart, if you want to see the unbelievable growth of administrators versus physicians over the last 30 years). Of course, a sector as big as health care does need some oversight, rules, and regulations — but we’ve gone too far.

That moment when a physician sits down with their patient, is what the practice of medicine is all about, and should take front and center stage in any health care system. So Doctor, this is your time. Make the most of it and let’s give patients what they deserve when we are face-to-face. Even if the rest of the world around us feels like its tumbling down.