Communicating With Patients
Medical oncologists spend a tremendous amount of time communicating vital information to patients and their families. In order to begin a treatment designed to attack cancer, much must be done to educate them about the goals of treatment, the limitations, the risks and side effects, and the logistics of the treatment schedule. This information must also be given in such a way that not only are patients enlightened about their therapy, but that all involved are satisfied that the oncologist is indeed:
A. competent - not ill-prepared
B. confident - not vacillating
C. compassionate - not callous
D. considerate - not inflexible
Since I have a keen interest in improving the care of cancer patients let me, T.C.O., provide some simple advice on how a doctor might fulfilll the basic requirements of effective patient communication.
The Cheerful Oncologist's Tips:
1. If feasible, always sit down when counseling - it sends the message that you are not in a rush to get out of the room.
2. At the beginning of the visit, learn the identity of all who are in the patient's room - relatives, friends, ministers, etc. It is courteous, and you never know who might be in there with the patient. It could be someone important in providing care, such as the patient's power of attorney.
3. Don't speak too rapidly, or shovel out reams of facts about the patient's case. People under stress cannot process a lot of data. Take it slowly, with pauses at crucial points in the relaying of information - especially if it is bad news. We all need time to react and it is doubly hard when stricken with a serious illness.
4. Never, never use medical jargon without immediately translating it into common English. It amazes me that some doctors still assume the average lay person is bilingual!
5. Look the patient and family in the eye! You wouldn't want to give the impression that you're lying to them or that you have no faith in the treatment you are proposing.
6. Of course, leave time for questions. If you know of a vital question that hasn't been asked, ask it yourself and then answer it.
7. Give some encouragement, for cryin' out loud! We oncologists are in the profession of killing cancer, relieving suffering, and prolonging lives - if we believe that our treatments can meet these goals then why keep it a secret? Why not make an effort to lift everyone's spirits, so that we all start out with dreams of recuperation, if not healing, if not triumph?
8. At the end of the visit go around and shake everyone's hand. Again, it is polite and it sends the message that this patient's welfare is now your mission.
Successful communication with patients is not difficult when you, the doctor maintain two visions - first of patients and families leaving despair and fear behind as a result of your counseling, and second of you, the doctor sitting in the chair occupied by your patient. Yes, just sit for a minute in this chair and imagine yourself waiting...waiting for the door to open, waiting for the battle of your life, for your life, to start.
You sure would want a good communicator now, wouldn't you?