Listen Up: Improving Communication in the Doctor-Patient Relationship (Part 1)
The Doctor as Listener.
I spent a lot of time practicing my profession struggling to listen to patients. In an attempt to learn how to be a better listener, I did what doctors do. I consumed books, listened to podcasts, and most recently, I started listening to a Vlog (video blog). One excellent Vlog, Lewis Howes' School of Greatness, had a guest named Robert Greene, who said that the root of poor listening is that “You are more interested in yourself than you are in the other person.”
That’s really great advice.
But the root of the issue in medicine is more complex. Social relationships aren’t the same thing as doctor-patient relationships. Here are some of my thoughts on things that are the same and different.
Caring about your patients is really fundamental to being a great healer.
People are now more likely to enter social AND doctor-patient relationships with baseline distrust. This seems to be part of our new normal.
In doctor-patient relationships, neither of us generally want to have to see each other again. The more the patient needs the doctor, generally the less healthy they are. No one wants that. Also, the more the patient has to see the doctor, the more time from their daily life and the more expensive it is for them. No one wants that either (except for the occasional Bad Egg cash focused doctor—Boo, Hiss). I’ll help you find ways to spot the Bad Egg Doctor in future episodes.
On the other hand, to solve a health issue conservatively (preventatively), sometimes it takes more time, more visits, more patience.
Patients are theoretically there to hear what you have to say, which primes the doctor for wanting to share their knowledge with you, and we have less time than ever to share it. This sabotages our ability AND time to listen well.
The doctor-patient relationship is fundamentally transactional. Patients are there to buy something from us—access to an educated, experienced perspective; prescriptions; referrals to specialists and surgeons; paperwork for medication, equipment, and work leave. Some of this work the doctor gets paid for. Some of this work they are expected to give away for free, and that can stress their business bottom line. Try to remember that doctors postponed their ability to make money for at least ten years, during which time they accumulated SOUL CRUSHING DEBT.
The US medical model sabotages doctor-patient relationships by prioritizing charting and correct coding over patient care. It’s exhausting for the doctor, and some can’t make it work. It isn’t in their skill set. They may be great healers but AWFUL time managers. This causes the doctor to enter the room in existential stress. No one who is that stressed out is primed to be a good listener.
I have some thoughts on how to improve this.
Please subscribe if you would like to hear more. We can’t fix the parts of the equation that our out of our power. But both patients and doctors can do some things to get the most out of the doctor-patient relationship.