Like in any relationship, listening is key
First of all, any great anything — friend, partner, doctor — is going to listen to you. Right? If you are going to expose yourself and make yourself vulnerable to somebody, you want to make sure that they will hear you and respect you.
—Elizabeth Kavaler, M.D., urologist/urogynecologist, Total Urology Care of New York
What does good listening look like? The doctor sitting at eye level with the patient, making eye contact, and at the right time, speaking loudly and clearly enough, with words that a patient truly understands.
—Susan Hassmiller, senior adviser for nursing at the Robert Wood Johnson Foundation, Princeton, N.J.
Sitting down with the patient says, “I have time for you.” I believe that saying, “People don’t care how much you know until they know how much you care.”
—Jay Kaplan, M.D., past president, American College of Emergency Physicians, New Orleans
The doctor should be interested not only in your chief complaint, but also in your chief concern. If you’re coming in for back pain, the pain might be your complaint, but your concern might have to do with babysitting your grandson. Will you be able to lift him? Will it hurt your back more to pick him up?
—Helen Riess, M.D., associate professor of psychiatry at Harvard Medical School and chief scientific officer with Empathetics Inc.
Often, a patient is embarrassed. What we’re talking about is really personal. So a patient will tread lightly and then wait to see whether the doctor can catch what they’re hinting at. If the doctor asks, “Are you sexually active?” and the patient responds, “Well, I’m married,” a great doctor won’t just write down “married” and move on. An engaged doctor will ask, “Wait — what does that mean?”
Active listeners leave some questions open-ended, so patients feel like they have the opportunity to explain what they’re experiencing, not just say “yes” or “no.”
Analyzing all outcomes
Find out what matters most to the patient. There are usually trade-offs. All of us want to be free of meds, free of pain, live forever and be functional, but that’s not going to happen. So what outcome is the patient hoping for?
—Mary Tinetti, M.D., chief of geriatrics at the Yale University's School of Medicine
Some drugs make you dizzy, others make you go to the bathroom all the time. A patient should ask the doctor, “What will my life be like on this treatment? And is that going to be OK with me?” So many times, doctors skip this step. You want to feel like your doctor is walking beside you.
—Rebecca Sudore, M.D., palliative care physician and professor of medicine, University of California, San Francisco
A great doctor is more interested in trying to get you off medications than on them. He or she wants to make you healthier overall, not just cure you of whatever problem brought you into the office that day. If doctors would focus on getting patients to eat healthy foods, exercise and quit smoking, it would have a more dramatic effect than all the pills and procedures combined.
—Robert E. Sallis, M.D., family practitioner, Kaiser Permanente Medical Center, Fontana, Calif.
Great doctors don’t make assumptions about people they’ve treated for a long time. Let’s say a patient visits often for headaches. It is easy to walk into that room and think, I’ll just tweak their meds and tune the patient out. But when you really listen, you may hear things like “I fell two weeks ago” or “I lost my job.”
—Earlexia Norwood, M.D., service chief of family medicine, Henry Ford Hospital, West Bloomfield, Mich.
Showing respect for patients and family
Respect is also key. In an office setting, a great doctor will not discuss important news or convey information until a patient is fully clothed sitting in the doctor’s office. This decreases the intimidation factor.
Address the concerns of any family members who are present, and provide a phone number in case there are questions. If the doctor can’t get to all of your issues, which happens often, they should politely say, “Let’s schedule another appointment to discuss that.” And if your appointment ends with a treatment plan, you want the doctor to ask you to repeat it back. That confirms that you have heard the plan and understood it.