Posts Tagged ‘miscommunication’

Joe and Terry Graedon interviewed me about my book Compartments on the People’s Pharmacy: Compartments and Communication.

Our interview was about how misperceptions can lead to communication difficulties that interfere with good health care. When people are operating within their own area of expertise, they may find it hard to understand what the big picture looks like from another person’s perspective. Whether the differences lie between doctor and patient or between different health care providers, the results can be unfair judgments and missed opportunities.

This  attitude can affect the way doctors interpret the results of placebo-controlled trials and how they feel about home remedies. We also discussed the pros and cons of e-mail communication between doctors and patients, and how to choose a good doctor.

Listen here and let me know what you think.

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On June 29, 2010, the New York Times published an article by Jennifer Schultz entitled Punishing Doctors Who Make You Wait, an article which begins by claiming: “There’s nothing worse than showing up on time for a doctor’s appointment and then having to wait because the physician is running late.”  According to our research at DrScore, that simply isn’t true.

Data from the patient satisfaction surveys collected at DrScore.com tell a different story.  While it is true that keeping patients waiting lowers patient satisfaction, it is only by a very modest degree.  Much more important in determining satisfaction  is whether the patient saw a friendly, caring doctor. When it comes to patient satisfaction, there’s nothing worse than seeing a doctor who you don’t think is friendly and caring.

Of course it is a bad idea to keep patients waiting.  But if patients are kept waiting because a doctor cares so much that he is giving each and every patient all the attention those patients need and deserve, patients are generally very understanding.

Schultz’s article goes on to suggest asking the doctor for a discount if the patient has had a long wait.  I’m not so sure that’s a good idea.  I’m willing to wait for my doctor if she’s busy with another patient who unexpectedly needed more time, because I know my doctor would spend more time with me if I were the one who needed more time.  That’s all the compensation I need.

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Another of the highlights of Nance’s book Why Hospitals Should Fly involves the importance of unambiguous communication and the need to seek clarity from others. The line that really caught my attention was, “I know you think you understand what you thought I said, but I’m not sure if you realize that what you heard wasn’t what I meant?”

All too often, in medicine and in life, miscommunications occur. When we say something, it comes from the context in which we are currently thinking. The receiver of the message may interpret the words in some completely different context. This can result in dramatic degrees of miscommunication between health care professionals and between physicians and their patients. These kinds of miscommunications are one element discussed in my book, Compartments: How the Brightest, Best Trained, and Most Caring People Can Make Judgments That are Completely and Utterly Wrong (www.compartmentsbook.com).

Nance points out that we should listen to people repeat back what they said to us. That’s one helpful approach. Having a buddy come with the patient to record key points is another. Written instructions may be the most valuable way to assure good communication between doctors and patients.

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My interview with the People’s Pharmacy radio program was broadcast on October 10. Visit (http://www.peoplespharmacy.com/2009/10/10/743-saving-your-skin/)

I thought the program, which was focused mostly on dermatology, went well. I was also able to speak on some other issues about which I have a lot of passion — in particular, patient satisfaction.

Unfortunately, I did not communicate one of my points very clearly, and a physician who had been listening to the show felt that I had insulted family physicians and posted a comment on the People’s Pharmacy Web site. Because I have enormous respect for family physicians and other primary care doctors, I felt terrible about the misunderstanding. But I greatly appreciate that the doctor wrote to me and to the show to let me know his feelings. It gave me an opportunity to respond to him and others, clarifying what I meant. More importantly, the feedback made me realize that in future radio programs I need to be more clear and explicit in letting listeners know exactly what I mean.

Ironically, this is the same kind of communication problem that doctors and patients —and everyone else — face day in and day out. At least in medicine we have one solution: give patients clear, written directions describing the diagnosis and treatment plan. But doctors, like everyone else, often don’t hear themselves and think they have communicated clearly when they have not. That is why it is so important for patients to help doctors by giving them the feedback about their communication style. I’ve said it many times: Feedback helps doctors do what they want to do most, which is to give their patients great medical care.

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