Back in 1998, I heard a trauma surgeon talk about communicating with patients. His words have stayed with me all these years.
The gist of his message was:
Physicians are as a group, are highly educated. A lot of the patients we deal with do not understand medicine, surgery, anatomy or physiology like we do. If we need to explain a procedure, the need for it or a disease process to a patient, we need to keep it simple.
Now that coming from a surgeon is deep!
It’s one of those things I’ve never forgotten. To keep it simple.
One can tell a patient:
“I am going to place a central line in your right internal jugular, float a pulmonary artery catheter and also place an arterial line in your left radial artery. You need that for your aortic valve replacement.”
Or one can say:
“To better take care of you during your operation, I need to place a larger iv in that vein in the right side of your neck. It helps us give you blood faster if you need it. Also, we feed a tube through it into your heart that helps us measure how much blood is being pumped in an out. You also need a better way of measuring your blood pressure. Feel your left wrist. Feel that pulse? That is an artery. I’ll put a small tube in there that will help measure your blood pressure better.”
Sure, the latter takes longer but you don’t have a patient who stares at you after you are done speaking like you just dropped from Pluto! We must all try to talk to patients in terms that are understandable to them. Terms that we take for granted may sound like Greek to most lay people. Even a term as simple as “colonoscopy” has befuddled some patients.
Some steps that can help me are:
I imagine explaining a procedure or even a disease process to one of my older uncles or aunties or to my kids. I break it down to a level they can understand.
I use diagrams that I sketch. I find drawing out the anatomy and pointing structures out and what is going to be done helps immensely. A lot of patients in Kentucky believe epidurals are the number one cause of paralysis in the world. A small drawing of the layers a needle goes through to reach the epidural space and it’s relatinship to the spinal cord helps immensely to allay some fears.
I encourage questions. If a patient can repeat what you said and base a question on that, your work is done.
Do not look at patients with disdain. It is not their fault that they do not understand what a myxomatous mitral valve is. I bet you do not know what Capital Structure Theory is either. A degree of empathy is needed to understand where patients are coming from. Without that empathy, it is difficult to relate to the patients and explain things to them at a level that is understandable.