Why Communication Is Absolutely Critical to Good Healthcare
Posted on Wednesday, September 5th, 2018
By Gary M. Verigin, DDS, CTN
Let your dreams be bigger than your fears and your actions louder than your words. – M. Scott Peck
We are living in chaotic times. The linear world humanity trusted in for centuries is being upended by something wilder and less predictable. Change brings challenge. Has humanity exhausted its ego and now doesn’t know what to do?
Rates of anxiety and depression are at all-time highs. Substance abuse and suicide rates are rising. More people seem to prefer a life of digital distraction instead of investing themselves in work or study, let alone critical thinking about the world around them. Our mobile devices deliver virtual life whenever we want it and constant amusement or outrage as we choose.
Meanwhile, our physical bodies, our emotions, our psychological and spiritual health too often get shoved down to the bottom of our priority list, buried under the pursuit of money, material items, romantic partners, or other external desires we believe will bring us happiness and fulfillment.
I see this in more than a few of the patients who come to me for help with restoring their health. I hear them living in the past or future, seemingly oblivious to what is going on right now.
Yet none of it matters without our health. It’s the first thing given to us when we come into life, and it’s the last thing taken from us.
“We Are Far from Achieving Patient-Centered Care”
Physicians and dentists are taught to categorize each patient by finding a diagnosis. The practitioner tries to find something wrong, while the patient, for the most part, wants support in staying well.
But this method of diagnosis relies on the mistaken belief that every patient is exactly the same – just like every Prius or Camry is the same as every other. Problem-solving is approached as one-size-fits-all.
Virtually every new patient we see these days tells us about how it always felt like their previous dentist or physician was always in a rush to get them out the door. They’re not just imagining things. According to a recent study out of the University of Florida, two-thirds of physicians fail to give their patients enough time to even explain why they’re there.
On average, patients get just 11 seconds to state the reason for their visit before their doctor interrupts them.
“Our results suggest that we are far from achieving patient-centered care,” study co-author Naykky Singh Ospina told the media, which is putting it most mildly, to say the least.
As for reasons behind being in such a hurry, the authors suggest burnout that many doctors experience could prevent them from adequately serving their patient’s needs. Other factors include time constraints dictated by the pencil pushers directing the clinics or simply not receiving strong enough training on how to communicate properly with patients.
I would offer that there may be other factors in play, as well.
What Patients Care About
One of the biggest problems is that, like our current president, many physicians and dentists think they’re the smartest people in the room – even as our culture now tends to devalue the expertise of professionals. Threatened, they assert their ego and intellect all the more. They tend to quickly dismiss the opinions of others and try to dominate decision-making, even when additional input and a broader perspective could bring about better outcomes.
They see the doctor as the boss. The patient who doesn’t obey is labeled “difficult” and “non-compliant.”
And where obedient patients tend to care more about what their insurance covers and how quickly their symptoms can be quashed, holistically and biologically inclined patients tend to care most about how their practitioners care.
Our goal is thus not to move patients through our office as quickly as possible so we can move on to the next. Rather, we listen and only then offer possible solutions to the concerns that patients bring to us.
“True listening,” wrote Virginia dentist Paul Henny in a recent essay in a newsletter called Thought Experiments, “requires a setting aside of ourself.” It means listening without a preset agenda in mind or trying to steer conversations toward our own goals or satisfaction.
The goal is to create a safe psychological space where the patient senses acceptance, and therefore feels less vulnerable and thus more inclined to open up and share their fears and concerns regarding dental issues.
Here, trust can develop and knowledge be shared as doctor and patient work together on a plan of action toward the patient’s desired health outcomes.
This takes another important skill: emotional intelligence. Two of the pioneering psychologists in this field, Peter Salovey and John Mayer, have described this as
the capacity to reason about emotions, and of emotions, to enhance thinking. It includes the abilities to accurately perceive emotions, to access and generate emotions so as to assist thought, to understand emotions and emotional knowledge, and to reflectively regulate emotions so as to promote emotional and intellectual growth.
Without emotional intelligence, it is impossible to truly understand a patient’s needs, let alone have much inkling of what their experiences of health or illness are like. It is impossible to see them as a whole, complex person.
“Always Show People You Care”
On our office home page, we list some of the things that our patients have told us they value about the care we provide. I’d like to draw your attention to two of them in particular:
The value we place on caring, helping relationships that promote a positive, caring atmosphere in our office and help you define your personal health and lifestyle objectives.
Our commitment to go beyond mere competence to find meaning and direction in a highly personalized, health-centered, graceful and creative environment, with an emphasis on long-term health planning.
We also “follow three rules,” in the words of famed football coach Lou Holtz: “Do the right thing, do the best you can, and always show people you care.”
In a world that promotes disconnectedness through the illusion of connectivity, we think this is especially important. So many people make themselves so busy, they’re not even aware of their needs or even their health – until something goes wrong.
If there isn’t clear, open, non-judgmental communication, it’s all too easy for the practitioner and patient to start working at cross-purposes. The practitioner provides what they think the patient needs. The patient can’t understand why they’re not being heard.
Good decision-making is impossible within the paradigm of medicine-as-usual, where the focus is on maximizing productivity and profitability for corporations. Instead of physicians, dentists, and other healthcare professionals, pencil-pushers run the show.
Any real discussion of health is easily muted. Doctors are reduced to repair workers laboring under a remedial philosophy with patients who are often dissatisfied with both their outcome and experience.
And the dysfunction deepens.
Here’s my question: Do people want dental and medical care to deal with actual issues that are bothering them or do they want corporate dentistry and medicine to go hunting for something wrong with them, regardless of what they’re actually experiencing?
I would hope that, even in this day and age, most people would choose the former.