Imagine sitting in an examining room, nervously waiting to speak with your primary care physician. Earlier this morning, you received a phone call from the nurse requesting your presence at the office as your physician urgently needs to discuss with you your latest blood work results. As your mind races with thousands of scenarios and diagnoses, each more frightening than the other, your physician enters the room with a grim look on his face…
May Allah SWT protect us from ever experiencing such a situation. However, such a scenario is something that we will eventually encounter with our patients, beginning with the clinic and extending throughout our professional careers. As students, we sometimes get excited and become all wrapped up doing the actual medical exams that we forget how it is to be the frightened patient that is hearing medical jargon tossed around him and cannot make heads or tails of why the student doctor is frowning intently at the medical chart. Attitudes and personalities are important in the clinic and the keys to a successful career.
The Prophet (peace and blessing be upon him) taught us to smile. So smile! Entering an examining room and smiling at the patient is one of the easiest ways to display confidence and lower a patient’s anxiety at the same time. It doesn’t have to be a big toothy smile, just a pleasant one while introducing yourself as a student doctor is more than enough. Next, make sure to ask what the patient prefers to be referred as; don’t automatically assume that she would like to be called “Mrs. Rochester”, or that James is “Jimmy”. Some patients would like to maintain the use of their full names, while others are more than willing to forgo the formality. Whatever they choose to be called, it works to start to build a patient-physician relationship.
What is also important is for you to slowly build up rapport between you and the patient by forming some sort of connection. For instance, when asking patient’s about their chief complaint, show some concern about the pain they’re in. If when taking down their personal history they mention their children, make sure to ask about them and congratulate them on any grandchildren. A few weeks ago, my classmates and I were graded on how comfortable the patient felt about us. Since the patient was a standardized patient (an actor so to speak), they were bale to provide us with constructive criticism and worthy feedback. As so, my evaluator gave me full marks as she felt relaxed with me and mentioned the fact that I sat on a stool during the patient interview removed the barrier of the foreboding glare of a doctor looking down on a patient lying on the examination bed. It seems simple and silly, but people really need to feel that someone actually cares about them. In doing so, they may open up and reveal to you other issues that will help clue you in to what their diagnosis may be.
Please, please do not use medical jargon with your patients! Unless you are treating a neuroscientist or a fellow healthcare member, refrain from using terms such as palpation and edema. To us, these are normal words, but to the lay person, especially a frightened one, just hearing these words may cause them extra anxiety. Try to say something along the lines of, “I’m going to apply some pressure here” or “You’ve got some fluid accumulation”. Even the word tumor automatically causes people to assume the worse, so be sure to mention benign versus malignant when describing it. As one of my clinical professors says, “when you deal with patients, always remember your first day in clinic..you had no idea what people were saying or doing!”.
When discussing treatment plans with patients, make sure to ask them where they live and if they will need any accommodations to external health services. Although you will not be providing the care or making the final decisions, the patient will be more likely to cooperate with the health team and less likely to discontinue their medical treatment. The overall benefit is for the patient to feel relaxed and willing to come back; so get rid of the frown and loosen up! You may be a ninja with the scalpel and can perform ten different types of bunionectomies in thirty minutes, but if you have poor communication skills or a condescending attitude, you ain’t going anywhere buddy. If you want to be a successful doctor, it starts from now!