I have been blessed to live in a country with excellent medicine, but I do not believe that I live in a country that rises to the potential of how excellent healthcare can be. What can aid healthcare in becoming truly great? Communication. Communication is a pillar of excellent healthcare. What good is excellent medicine without good execution of it? And how can it be properly executed without exceptional communication?
As a patient, I witness a lot of what I call auto-pilot communication from healthcare providers. It’s going from task to task, person to person, getting the job done but not being fully present. It is here that communication is being done, but what is being communicated is at risk of getting lost in translation. Perhaps the provider didn’t communicate something as clearly as then meant to, or the patient wasn’t as well versed in health literacy to have been able to understand what was being said. Or, ironically, the provider assumed the patient was not versed in health literacy and simplified what they wanted to communicate in an effort to accommodate the patient but instead provided less information than they could have.
Communication isn’t as simple as just saying words; it is a process. When I think of communication, I think of three stages: preparation, delivery, and follow up.
Preparation is perhaps the most important stage of all, or at least the stage that requires the most conscious thinking. Before a single words comes out, one should ask themselves, “What am I trying to communicate? What are my goals, and how do I get there?”
Second is delivery. It is at this stage where one can prevent the words you are about to say from getting lost in translation to the patient. “Who am I talking to, and what do I know about them?” If you don’t know anything about them, switch to “what can I infer about them?” We can learn about someone’s communication preferences by mirroring how they communicate to us. I’m very type A in my communication style, this is a reflection of how I want to be communicated to. Check my chart and you will find that I have a very long and complicated medical history. This is how I learned the healthcare lingo.
The third and final stage is follow up, which might look different depending on the situation or your role in the healthcare system. Verbally recap the conversation and next steps to establish expectations between you and your patients. “I’m going to do X, and you’re going to reach out if Y happens.” Naturally the conversation you have with a patient may bring up some questions you can’t answer in the moment. If you don’t have an answer, say, “I don’t know.” Admitting you don’t know gives you creditability. Then, follow it up with how you plan to find an answer and how to specifically plan to follow up with the patient. “I don’t know, but I’m going to find out and give you a call/send an email.”
Communication is difficult, and we undermine how difficult it is. If we put as much time and effort into teaching communication as we do in teaching medicine itself, we would live in a tremendously different world, one that I believe would have much less heartache. I’ve always found it funny that there are procedures deemed as “non-invasive.” Our healthcare system is invasive, and it is invasive in every possible way it can be; financially, emotionally, and literally, physically. It is also an incredibly intimate system; this is our bodies we are talking about. A healthcare system that is simultaneously intimate and invasive can feel cold and mechanical. Communication brings the warmth back; it brings the human quality back. It eases the trauma and fear that comes with being ill. Without it, the patient-provider relationship is strained. Patients feel lost, distrust of healthcare providers and the system grows, and treatment outcomes are negatively impacted. Healthcare without communication can cause more suffering than the disease being treated. We owe it to ourselves and each other to communicate. We’re not toasters fixing other toasters, we are humans treating other humans.
For more ideas on how to connect and communicate with patients, download Best Practices for COVID-19 Patient Communications.