Listening to your fellow human

During today’s Shared Decision Making exercise, the importance of how a provider/caregiver first opens the conversation sets the stage for the rest of the visit. The first “Clinician” to go began by speaking about the disease state and laying out options and very much talked for a solid 2 minutes before opening up the conversation to the patient. In the subsequent scenarios, our group felt that by asking the patient as soon as possible how they felt about their situation and what their preferences were regarding their concerns and treatment allowed for optimal flow in the “visit.” Additionally, when thinking back to how the Neurosurgeon in the Michael Skolnik documentary first began the conversation with the Skolniks, he began by saying, “I’ve been having the worst year.” When a patient and a caregiver converse, it is not about the caregiver. It is about the patient. When delivering bad news, it is always best to get directly to the point without sugar coating the news, or trying to hide mistakes or failures. In the Neurosurgeon’s case, he went about numerous iterations of circumlocution, failing to simply tell Michael’s parents up front, what had happened to their son.

Establishing rapport with a patient is critical. Moreover, allowing the patient to voice out their concerns and actually addressing those concerns in an open, transparent, up front manner stands at the crux in creating an environment of shared decision making. We need to become the providers that hear and truly listen to our patients. We have a responsibility and duty to protect and do no harm. Each time we interrupt and truncate the patient’s story in a reductionist manner or belittle their intelligence by hand waving and misleading them, we are doing everyone a disservice. Many of us are early in our medical careers, but I hope that we take with us the joys of listening to our patients and the warmth that comes with respecting them and seeing them as human beings and not simply “patients.”

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