I mentioned in my last post how there a lot of subtle body language cues and voice inflections that go into dealing with patients. I got to thinking about my rules in dealing with patients, my little pointers that I would pass on to someone going into medicine. I wrote a couple of them down. It will be interesting in a couple of years if my perspective changes on this. I may look back years from now and say how stupid or naive I was in writing this, but I feel right now like these are pretty solid ones.
1. Sit down and speak eye level with a patient, never talk down to them if you can help it.
You'll notice that some people are immediately confrontational if you stand there talking while looking down at them. It's much better if you find a chair or seat 2-3 feet from them at eye level.
2. Always explain; do it slowly and patiently (even if you don't feel that it needs done).
People often really appreciate it if you take 5 minutes out of your day to educate them on what is REALLY going on. I break it down very simply and explain what is causing there problem (if I understand it myself ;P), sometimes understanding a problem is as relieving as the medicine.
3. Don't use big words, speaking to a patient isn't the place to show off your education.
I had the displeasure of working under a doctor who would push his ideas and treatments onto people by saying big words. "Ohhhhh you've got Myotonic Dyskenesis...You should take my vitamin supplement." (He was more of a snake oil salesman than a doc). I don't really know if Myotonic Dyskenesis is a real disease, it's medical Latin for "muscles that move wrong". If you can help it never use medical words in conversation with a patient. Use it for naming the disease, don't use them in anything else and if you do, explain what they mean.
4. If you don't know, don't hide it, explain and tell them you'll find out.
Amazingly it's appreciated when you cop to your ignorance, it shows you know your limits, and patients trust you more for it. Just do your best to find out and you'll be great in their eyes. Plus it's much easier to me than trying to bury their question under a pile of BS and big words, which more Doctors do than you would imagine (not a ton, but more than their should be).
5. Fix your mask on tight even before entering the room. You never know what they will say.
A good portion of "being" a doctor is acting. Among your friends and family you are allowed to be yourself, but in a room with a patient, you must be non-judgmental, passive, and more mature than anyone you'd ever care to meet ;P I had to put stitches into a kids leg last night (huge knee wound, almost to the bone), sweat was pouring from my face as I did it...it was nervousness, but I asked the nurse very nicely to blot my forehead and I finished without incident. If that kid knew how nervous I was or if I had acted the least bit freaked out by his wound, none of what we did that night would have worked with him...the patient has to buy into you as the doctor or you can't help them (or at least not near as well).
6. Don't be afraid to show that you are human, just do it in a controlled and intentional manner.
If a patient tells me something horrible, I will empathize and acknowledge it, but it doesn't do the patient any good if you are overcome with emotion and can't do your job. Some might debate me on this.
7. When you don't know what to say, sometimes silence is the best answer.
I remember this mother finding out she had inoperable cancer in her stomach. I didn't have clue what to say. Something made me keep my mouth shut, but I sat with her and her husband as they cried, and when they were done, then we talked, but sometimes your silence and time is all there is to give.
I'm going to stop at 7, cause the others I can think of aren't that interesting (ie. how to sit when talking to a patient). But if I think of anymore I'll add to this and change it as my experience dictates. Thanks for listening guys.
Newbie Doc
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