Five Conversations Every Doctor Eventually Needs To Have With Their Patients
Whether you’re a first-year medical student, a resident, or a veteran physician, one thing that hallmarks every stage of a doctor’s career is dealing with patients. A big part of this comes down to assuaging fears and answering questions in a way that reassures your patients.
And as any doctor can probably tell you, given enough time in the field, you’re apt to come up against the same problems, ridiculous expectations, and silly questions. This is part and parcel to the job; but, can all change when certain boundaries are crossed and in turn create a power imbalance between the physician and the patient. More often than not, this necessitates open dialogue.
Dealing with the rigors of a doctor means you routinely need to take a clinical approach. For someone who doesn’t have the context of having to make life and death decisions on a daily basis, this can often come off as being aloof or cold. If you find this becoming a trend, it may require stepping back and empathising with the patient to a great degree, or reassuring that you do care. Humility is key and can often repair a broken doctor-patient relationship.
Personal vs. Private
There is this odd expectation that doctors are 24/7 hour machines. Being able to separate your life in the hospital from your private life is essential, and sometimes it’s easy for even doctors to remember this when their patients are very demanding. Setting clear boundaries in terms of what you can and can’t do can go a long way towards clarifying your role. Don’t be afraid to be firm.
With the Internet and sites such as WebMD, many patients come with preconceptions about their condition and may even try to correct you or diagnose themselves. This could be for any number of reasons, including embarrassment about a condition or being in denial. A lot of compassion and patience can help ease them into acknowledging their symptoms and building trust.
In the same vein, having a degree of transparency between physician and patient is crucial, but it isn’t always easy. Your patient may not be up front about taking medication as prescribed, and as a doctor you may feel uncomfortable giving honest appraisal and medical advice (for example, telling a patient they need to lose weight). Establishing rapport and being concrete in your descriptions and diagnosis is therefore essential – even from the onset!
As a minority or a woman, this is an unfortunate reality. Some patients may question your competence, refuse to take advice, and act belligerently because you don’t fit their “ideal” of a doctor. This can be one of the most trying conflicts for a physician and may even require a deferral to upper management – but where possible, a candid conversation with the patient about their views and the impact it has on you can sometimes salvage the relationship.
Just as there is no perfect patient, there are no perfect doctors. At times, you may find yourself being held to impossible standards but the most important work you can do is to balance striving to meet these expectations and being honest with informing patients, and colleagues alike, of your limitations.