The Doctor Is in the Details

Kendra Campell -- I’ve always tried to be a good communicator. I really enjoy conversing with other people, and I consider myself to be fairly cognizant of others’ reactions. I try to alter subtle details of the way I speak depending upon who I’m talking to, and what the circumstances are. I’m certainly not perfect at it, though. And the more deeply I delve into medicine, the more I realize how critical it is to be able to effectively communicate with patients. I can only hope that I’ll do a decent job when I actually start working on the wards.

I once observed a fellow student interview a patient who had a very long list of complaints. After the patient finished describing each complaint, the student said, “okay, and that’s it?” The student was obviously hoping that the patient had no more problems that they’d have to explore. It was quite apparent that the patient quickly caught on to the student’s annoyance, as she eventually gave less and less information about each complaint.

Another time, I heard a patient mention that they used “bush medicine” to help treat their headaches. This being a Caribbean country, many people treat various ailments using bush medicine. However, instead of asking more about the type of treatment that was used, the student condescendingly said, “okay, so you don’t take medication, and you still feel worse.” The expression on the student’s face was obviously one of disapproval. It’s nearly impossible to get a history from a patient if you quickly dismiss what they’re trying to explain to you.

We’ve probably all seen at least one med student get so wrapped up in taking a history or performing an exam that they walk into the examining room without introducing themselves or asking the patient’s name. This “lack” of communication with the patient certainly does communicate a lot!

There are so many intricacies involved in the doctor patient relationship that it’s impossible to master every detail. But as a future doctor, I want to attempt to do the very best job that I can with every patient. A simple smile or an understanding nod can ease a patient’s anxiety and allow them to open up to you. Communicating effectively with patients is not just about the questions you ask, but rather how you ask them. The tone of your voice and the reaction on your face can frequently communicate more to your patient than their lab results or their diagnosis.

Taking a good history and being a good doctor requires paying attention to even the most seemingly insignificant details. Many doctors might be very adept at scrutinizing their patients in every way, yet they forget to turn their astute powers of observation on themselves. I hope that in my future practice I can remember not to focus so much on my patient’s details that I forget my own.