Tuesday, October 6, 2015

Doctors are Educators

Today I started my elective in Hematology Oncology, which I have a personal interest.  I think this field of medicine is extra delicate.  When most patients go see their primary care physician, it's considered preventative care or managing chronic illnesses.  However, if you have an appointment with a Heme/Onc it's  may be because a diagnostic test was abnormal and further investigation is needed. 

What's really concerning me about the doctor patient interaction is the lack of successful communication.  Communication is successful when the message intended is received and understood by the receiver.  I noticed in some cases of the underserved communities, some patients have no idea why they were referred to a specialist.  The were just told that their labs were abnormal and they need to see a specialist.  Just imagine the anxiety that could build from this form of communication.  The patient has very limited information. 

Today, I was interviewing a 62 year old Caribbean Afro male patient and he was under the impression that he was referred to this office because of the lingering pain from a object falling on his foot.  I thought to myself, "hmmm, I did not know this was a pain management office, too."  However, the truth of his situation was he had an increase in platelets which is called thrombocytosis; also, his hemoglobin and hematocrit were significantly elevated.  After the doctor explained this to him, he said he had never heard this before.

I love the way the doctor handle this. He explained to him the results and reassured him that he will received treatment for it. But, first more specific test were needed.  You should have seen the look on the patient's face, a sigh of relief, but confusion as well.  He was told that a "bone marrow aspiration" was needed.  The doctor excused himself from the exam room for a minute.  Then I asked the patient did he understand what he was talking about.  He said, "I have no idea. I guess this is why I have the pain?"  The doctor returned to the room and began to wrap up the visit and asked if there were any questions.  The patient said, "no." 

I'm learning that I have to, not only listen to what the patient says but, I must look at their body language, facial expression, etc.  This is all part of effective communication.  It was obvious that he did not understand one word the doctor was saying.  So, I interjected and said, "Actually, doctor Mr. X expressed to me that he was not sure of what a bone marrow aspiration was or why he needed it."

Communication is a huge part of effective patient care.  I am learning that I cannot only diagnosis and treat; but, I have to make sure those under my care understand and agree with the treatment.  After all, it is affecting them.

As you go through your day, interacting with others, pay attention to the nonverbal signs.  A lot of misunderstandings can be avoided by slowing down and really making sure the message intended was received and understood.

At the completion of this patient encounter, Mr. X thanked me and said, "we need more doctors like you."  Now, that's what this is all about...making a difference one patient at a time! Doctors are Educators....

Now, go live your dreams!


  1. Excellent points here. I definitely think you already understand communication with patients better than some doctors do! It's so important to pay attention to what the patient is saying AND not saying.

  2. Excellent points indeed. I work in a Hem/Onc office and this is an all too familiar occasion at the clinic. At first I thought it was a racial and age barrier because we're located in a large urban area. However, I was wrong. It affects all populations and it is primarily related to the doctor patient communication. Thanks for being aware and being an advocate for patients.