Charting the chats among doctors and patients
Doctor-patient chats — like conversations down at the corner store or the dinner table — sometimes wander a bit. As a doctor, I try not to be bossy in forcing the conversation back on course. I think it's important for the patient not to be overly nervous about wasting the doc's time. So I reckon I can take on the responsibility to remember, maybe even jot a note, to bring the chat back to high blood pressure or sleep problems or whatever the patient started with.
A recent, intriguing study of doctor's time-management practices touched on this point. It recommended doctors verbalize that they and the patients have reached consensus concerning the ailments and the recommended remedies. Come right out and say it. Sometimes the patient then says, "Wait a minute," then perhaps the chat goes back to square one or at least back a few squares. And that's okay. Let's take the time to get it right. It's common sense but perhaps it needed to be stated in this study.
The recommendations came from a survey overseen by researchers at the University of Washington and the University of Rochester. The researchers make the point that the doc should channel into the viewpoint of the patient, understand how the medical issues impact her. What about her lifestyle? What about her family's point of view?
And again, deep into a vein of common sense, the doctor needs to listen. Really listen. Often, a doctor suggests a course of action and a patient quietly says, "okay," but body language says otherwise. She shrinks back into herself. The doc needs to be alert to that. It's best to find out up front if a patient is uncomfortable with executing a piece of advice. Doctor-patient chats structured like this lead to better health outcomes, lower costs, and fewer malpractice claims, the researchers say. I say, "Pull up a chair. Let's talk about what ails you." I believe in chairside manner before it becomes bedside manner.
