Doctors Communication Skills - What Did the Doctor Say?
One of the most important skills for a doctor is the ability to meet the emotional needs of the patient.
Recently I have had the privilege to coach a friend who had cancer but thankfully is now cured.
As I talk to patients recovering from cancer I frequently hear stories of how doctors mechanically convey information to patients about their diagnosis or test results whilst showing little or no empathy towards that patient.
When you are ill the doctor becomes a very important person, however it would be wrong of doctors to assume that patients will listen to every word a doctor says when they are giving back test results or giving a prognosis to a patient.
The key reason the patient may not hear everything the doctor says is down to emotion and how a patient interprets information when they are emotional? Emotions can prevent us from having access to all that we know.
When we are gripped by an inappropriate emotion, we interpret what is happening in a way that fits with how we are feeling and ignore our knowledge that does not fit.
After emotional episodes a person can be in a refractory state, during a refractory state our thinking cannot incorporate information that does not fit, maintain or justify the emotion we are feeling.
When refractory periods are brief (lasting a second or two) they provide benefit in that it focuses our attention to the problem at hand, using the relevant knowledge that can guide our initial reactions, as well as preparation for further actions.
If the refractory period lasts longer (minutes or hours) A too long refractory period biases the way we see the world and ourselves.
During refractory periods people will reject contradictory information.
Consider a patient who has just been told they have cancer.
This person may have a refractory period that lasts for hours and during this time they will reject contradictory information that does not support the emotion they are experiencing (most likely fear and anxiety) this confirmation bias is extremely important for the doctor to know.
The doctor may continue talking to the patient giving balanced information but the patient may not hear what the doctor is saying and /or only select parts of the information in the doctors conversation that support the feeling of fear and anxiety.
The patient may miss that the doctor may have said survival rates for this type of cancer are very high, because this is contradictory information and does not support the feeling of fear.
When conveying information doctors need to be attuned to the emotional state of the patient or family member receiving the information and adjust their own messages to ensure the full and real message is received.
When Doctors convey information to the patient or family member it may help the communication process if the doctor breaks the message into two stages.
1.
State the message to the patient or family member.
2.
Ask the patient or family member to reaffirm/repeat the message back.
This would ensure the doctor that the patient or family member has actually heard the real message being conveyed as opposed to an incorrect interpretation or mental selection of information that lends support to the emotions (which in the cancer case are anxiety and fear) that they are experiencing.
Every day doctors give back test results, break bad news, diagnose and give their prognosis to patients and family members.
If doctors can learn to spot the "refractory state", whilst in conversation with a patient and they take just a few more minutes to ensure the real message is received by the patient, they get the opportunity to meet emotional needs of patients with every conversation!
Recently I have had the privilege to coach a friend who had cancer but thankfully is now cured.
As I talk to patients recovering from cancer I frequently hear stories of how doctors mechanically convey information to patients about their diagnosis or test results whilst showing little or no empathy towards that patient.
When you are ill the doctor becomes a very important person, however it would be wrong of doctors to assume that patients will listen to every word a doctor says when they are giving back test results or giving a prognosis to a patient.
The key reason the patient may not hear everything the doctor says is down to emotion and how a patient interprets information when they are emotional? Emotions can prevent us from having access to all that we know.
When we are gripped by an inappropriate emotion, we interpret what is happening in a way that fits with how we are feeling and ignore our knowledge that does not fit.
After emotional episodes a person can be in a refractory state, during a refractory state our thinking cannot incorporate information that does not fit, maintain or justify the emotion we are feeling.
When refractory periods are brief (lasting a second or two) they provide benefit in that it focuses our attention to the problem at hand, using the relevant knowledge that can guide our initial reactions, as well as preparation for further actions.
If the refractory period lasts longer (minutes or hours) A too long refractory period biases the way we see the world and ourselves.
During refractory periods people will reject contradictory information.
Consider a patient who has just been told they have cancer.
This person may have a refractory period that lasts for hours and during this time they will reject contradictory information that does not support the emotion they are experiencing (most likely fear and anxiety) this confirmation bias is extremely important for the doctor to know.
The doctor may continue talking to the patient giving balanced information but the patient may not hear what the doctor is saying and /or only select parts of the information in the doctors conversation that support the feeling of fear and anxiety.
The patient may miss that the doctor may have said survival rates for this type of cancer are very high, because this is contradictory information and does not support the feeling of fear.
When conveying information doctors need to be attuned to the emotional state of the patient or family member receiving the information and adjust their own messages to ensure the full and real message is received.
When Doctors convey information to the patient or family member it may help the communication process if the doctor breaks the message into two stages.
1.
State the message to the patient or family member.
2.
Ask the patient or family member to reaffirm/repeat the message back.
This would ensure the doctor that the patient or family member has actually heard the real message being conveyed as opposed to an incorrect interpretation or mental selection of information that lends support to the emotions (which in the cancer case are anxiety and fear) that they are experiencing.
Every day doctors give back test results, break bad news, diagnose and give their prognosis to patients and family members.
If doctors can learn to spot the "refractory state", whilst in conversation with a patient and they take just a few more minutes to ensure the real message is received by the patient, they get the opportunity to meet emotional needs of patients with every conversation!
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