Monday, April 26, 2021

by Dylan Chadwick

When asked to describe anxiety, I often defer to the description I’d give my college therapist. Anxiety fits somewhere between “simple worry” and “full-blown panic.” I’d compare it to the dull, but consistent bellowing of a gaggle of monkeys let loose to tromp around the recesses of my brain. Everyone experiences anxiety in some fashion, whether responding to an overwhelming work schedule, an impending deadline or even as a generalized disorder. Physicians certainly aren’t strangers to anxiety-provoking work either, especially those who work in emergency capacities. 

But while the individual and observable symptoms of anxiety vary from person to person, the overall obstacles it presents are quite uniform. Anxiety and stress are animal instincts, ones which protect us in dangerous situations and motivate us to seek equilibrium and control when we are losing it. However, anxiety can also be an impediment to relationships, an all-encompassing, slippery paralysis that crowds out our ability to think rationally, to make positive judgments and to hear what we most need to hear while in its throes: sound counsel.

When a patient visits their physician, they’re prone to feeling a little anxious. Diagnoses and treatment plans, loaded with obtuse medical jargon, can put ones mind in a tailspin and set one’s heart a-flutter. Not exactly prime condition to take medical advice. Wary physicians should consider the implications of a patient’s anxiety when dispensing information, in order to ensure they’re communicating clearly and effectively, and in a way that will benefit the patient long after they’ve left the exam room. Here’s some tips on how physicians can key into those feelings, work within them, and help patients feel less anxious in the process.

Open the Floor

Effective physicians will work to create an atmosphere in which patients can verbalize their concerns, questions and anxieties, and will work to address those before even moving into a treatment discussion. In an office visit, a patient has many more thoughts going through their minds than what’s on the surface. In these experiences, physicians should open the floor to patients, ensuring them that their questions and concerns are not only valid, but an integral part of treatment. Some patients may not feel comfortable articulating their inner concerns, and in these circumstances, a warm invitation to do so will carry much weight. A willing and listening ear can also calm the nerves of an argumentative patient. Ultimately, when a patient comes to a physician’s office, they’re bombarded with information that can be both frightening and confusing. Creating a scenario in which they’re given clearance to air out their fears not only helps them manage and regulate their emotions, but also helps the physician tailor treatment specific to their needs in the long run. 

It also goes without saying that there truly is no patient concern that is “wrong” or unimportant. Uncertainty is an unpleasant feature of many medical experiences, but a physician who will set the tone with warmth and an open mind will help alleviate anxiety’s burden.

A Room of One’s Own

A medical practice can be stressful environment, especially when dealing with a pandemic. Patients are surrounded by foreign looking equipment, strange sterile smells, and often the intermittent bustle of physicians, nurses and other specialists conducting serious and time-sensitive work. Environmental distractions can exacerbate a patient’s anxiety, leaving them feeling cagey and alone and in a strange environment outside of their normal comfort zone and preference. It’s beneficial for physicians to help control that environment, and create the most quiet, and private place possible so as to dispense medical information in as clear a manner as possible. Besides ensuring that information isn’t misconstrued, it helps quell the rampant anxiety provoking factors present in a high-energy workplace, putting fretting patients at ease.

Words Unspoken

Often it’s not just the words one uses, but the body language that accompanies the delivery of those words. It’s important for physicians to remember how their nonverbal body cues will affect a patient’s understanding and emotional processing of the information. Simple things like smiling and maintaining a calm and collected voice and speaking in soft, yet audible tones, can quell the alarming feelings potentially welling up inside a patient’s mind. There’s really no deep and nuggety magical formula for it. Physician’s should simply be nice and relaxed with patients, clear and controlled in their delivery. It lends an air of stability to the proceedings and will help manage the expectations of the room.

Silence Isn’t Always a Bad Thing

We all hate uncomfortable silences and will often seek to avoid them at all costs. They don’t always indicate that a conversation is going poorly though. In fact, when given such high levels of sensitive information, many patients need some time to process and digest the lofty information they’ve just been given. A well-placed section of “breathing time” is often an indication that new and useful information is being processed. When a physician is hasty to “force” conversation in these instances, they can come off as rude and insensitive. Furthermore, patients may not want to speak at all. While it’s important to always open the floor, physicians must also respect an anxious patient’s desire to simply listen and absorb information.

Choices Empower Patients

Anxiety makes people feel powerless to their emotions or the circumstance at hand. When confronted with a serious health issue, many patients resort to dread and anxiety because they don’t feel equipped to deal with the problem. Physicians should be sure to outline multiple choices (where applicable) for treatment options. When a patient knows they have choices and options for their treatment, they feel empowered and capable to deal with the problem, and also feel that their physicians are on their “team.” It’s also important to remember that even though a physician knows all the nuances and options of a treatment regimen, a patient may not, or may have a significantly limited understanding of it. Let them know that they have options in how they choose to be treated, and aren’t being forced into something without having an opportunity to weigh out the pros and cons.

Enlist the Aid of Family or Trusted Friends

There are those circumstances when patient anxiety is extreme and a patient needs someone there to help them on a more intimate emotional level. It’s not uncommon for patients to enlist the aid of a spouse or trusted family member to help them receive their treatment options and have said family member accompany them on their visit. In these circumstances, a level-head and an extra set of ears can ensure they the patient gets the most out of their treatment. Healthcare is a joint effort with patients and their families, and some family members need only to be taught how they can participate. In all circumstances, especially ones which involve rigorous or disruptive treatment, it’s crucial to get family members on board because when patients feel that they have a team of supporters backing them, they no longer feel alone in their problem. Furthermore, family members can help the patient with alternative perspectives or simply just comforting words that a physician simply cannot. 

Physicians are trained to diagnose and treat every level of medical problem and ailment in the known universe. However, beyond medical diagnoses, an understanding of patient anxiety, and the emotional/logical stranglehold it can wreak on its victims, will improve a physician’s ability to dispense information clearly and concisely, as well as tending to the emotional healing of a patient. 

References

RN, Gina. "How Touch Can Calm Patients." 

            KevinMD.com. Kevin MD, 19 Jan. 2012. Web. 18 May 2015.

Osbourne, Helen, M.Ed. "In Other Words...Know When to Speak and When to Listen...Communicating With People Who Are Anxious or Angry." 

            Healthliteracy.com. Health Literacy, Oct. 2005. Web. 18 May 2015.

Tartakowsky, Margarita, M.S. "3 Practices to Calm An Anxious Mind." 

            Psychecentral.com. Psyche Central, n.d. Web. 18 May 2015.