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Ryan Fitzgerald, DPM
PRESENT RI Associate Editor
Hess Orthopedics &
Sports Medicine
Harrisonburg, Virginia
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Through the Looking Glass:
A View from the Other Side of the Hospital Bed
I recently had the opportunity to spend a great deal of time in a local community hospital in an unusual capacity — that of the anxious family member awaiting news on an ill relative. It was an eye opening experience, on the nature of communication between physicians, their patients, and the patient�s family members. I would like to share with you, if you�ll indulge me, some of the experience, and perhaps together we can come to some better understanding of the nature and necessity of the communication — and how we can do it better.
As is likely the case with many of you, I am comfortable in hospitals. I have spent the last seven years in an out of hospitals in various roles. I have been a student, an extern, a resident, and most recently, an attending physician in private practice. It was an odd experience to be sitting on the patient’s side of things, waiting for the physician to round so that we [the family] could get updates on treatment options and potential courses of action. In this particular case, my ill family member had a series of physicians, some of whom were very good and others who left much to be desired –and my family’s perception regarding their ability to perform seemed to stem directly from these clinicians’ ability to adequately communicate. They were perceived as “good” or “bad” based upon how they conveyed their ideas, how they spoke, and how they answered questions.
I found this to be extremely interesting. Knowing nothing of their training or background, my family assessed these clinicians SOLELY as being good or bad based upon their brief interactions in the hospital room. Imagine that. Your entire training and background, meaningless, in those first ninety seconds — where it is your ability to communicate on which you aptitude and ability will be judged.
Throughout our residency training, there is significant focus geared–appropriately so — toward surgical and medical management of the patients under our care. However, there certainly appears to be paucity in the training of basic communication between doctors and their patients — this is of particular concern when it is our ability to communicate, on which we will be primarily and summarily be judged.
Have you ever thought about it? How well do you communicate with your patients? I must admit that this experience has forced me to critically evaluate my interactions with my own patients to improve this aspect of the care that I provide. Do I explain things in a way that my patients truly understand? Do I adequately answer the questions that are asked? Do I truly convey that I care?
It is important to ask yourself these questions, as you progress through your training and as you progress beyond into your career –as with most things, competence comes with persistence and with practice. What is certain is that if you are not training to improve your communication skills, you certainly won’t get any better.
Perhaps the most telling moment for me during these last several weeks regarding the importance of communication came near the end, when the doctor came into the room and said “I’m sorry, there is nothing more we can do.” More than just saying it, he genuinely seemed to mean it, and as I watched, my family, though stunned by the news, rose to hug him and thank him — he, who had delivered the worst news of all — for the good work he had done.
Success or failure is more than the surgical outcome. It is important to cultivate a connection with your patients, and to communicate effectively with them, and their family members. In doing so, you will be helping to treat not only their bodies but their spirits as well.
We at PRESENT love hearing from you, and look forward to learning from you. I encourage you to post your interesting cases, thoughts on this topic or any other, or questions in the eTalk section of PRESENT podiatry to promote our collective knowledge. We look forward to hearing from you!
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