I treat my patients as thinking, feeling beings who can make their own choices about their health and their life in general. I call them out on their bullshit and try to find out why they're making the choices they do. There's no point in preaching at a patient about not eating fruits and veg if the food bank has been out for a month.
I don't use flowery language because unfortunately, most of my patients are illiterate. When I started practice, I assumed many would be health illiterate, but I certainly wasn't expecting this. My staff has stepped up (I love them so) and help my patients to fill out the millions of forms that we process every month. I've stopped playing along with "I left my glasses at home" and ask them straight out how their reading is. They've been so used to lying about it, it takes them back and puts them on the defensive for a minute or two until they realize there's no judgement, just me looking to do best by them. I've gotten into the practice of reading out my referral letters to my patients so that 1. I have to finish it while I'm in the room with them, 2. they know what I'm saying about them and 3. they can correct me as I go along. My patients frequently laugh at my "doctor words" that go into those letters. That lets me know that the way I'm speaking with them is different than how I speak with other docs. I like that.
From the stories I hear from my patients, they haven't had someone who will actually listen in a long time. They get painted with the same brush as their drug dealing brother, as their morbidly obese mother, and as their father who has been in and out of jail since they were born. These folks are rarely treated as an important individual.
The same approach works for those patients I have with money and more stable upbringing. I fancy up my language, but otherwise, I continue to treat them as individuals. I don't care that you were mayor for 20 years, we are just starting a relationship, I want to know WHO you are, not what other people see you as.
Part of my approach has to do with my appearance. I've written about this before and I think I've made it clear that I am an untraditional appearing doctor. Most patients ask to see the doctor after I've been in, even when I clearly introduced myself at the beginning. Their response is not one of disbelief but of relief. "oh! you're like a real person!". I'm a bit quirky, I'm overweight, I smile all the time, especially when I don't feel like it. When my patients die, or I need to give someone bad news, or someone has divulged some horrific part of their life, I cry with my patients. It's the only way I can think of to let them know that they matter to me.
I also have a strong feeling for what is and is not fair. This is something that comes through whenever I talk to a child living well below the poverty line. Their anger and emotional outbursts are almost always associated with a feeling that something that has happened is unjust. I grew up well below the poverty line and I still get surges of rage when things are unfair. I've learned to breath deeply, reconsider my stance, and decide whether or not I need to proceed. If I need to proceed, look out. It will feel like molten lava is being rained on your head, because on top of my previous poverty speak, I am now also fluent in affluence, biz speak, economics, and ethics.
This all sounds very Polly-Anna-y, and it might be. Putting my personality in with a hospital that has administration that could, easily, use walkers, doesn't always work. I'm optimistic though that I can persuade admin to my side even through continuing to be patient centred. It's in the mission statement of every hospital of Ontario, including ours.
I don't use flowery language because unfortunately, most of my patients are illiterate. When I started practice, I assumed many would be health illiterate, but I certainly wasn't expecting this. My staff has stepped up (I love them so) and help my patients to fill out the millions of forms that we process every month. I've stopped playing along with "I left my glasses at home" and ask them straight out how their reading is. They've been so used to lying about it, it takes them back and puts them on the defensive for a minute or two until they realize there's no judgement, just me looking to do best by them. I've gotten into the practice of reading out my referral letters to my patients so that 1. I have to finish it while I'm in the room with them, 2. they know what I'm saying about them and 3. they can correct me as I go along. My patients frequently laugh at my "doctor words" that go into those letters. That lets me know that the way I'm speaking with them is different than how I speak with other docs. I like that.
From the stories I hear from my patients, they haven't had someone who will actually listen in a long time. They get painted with the same brush as their drug dealing brother, as their morbidly obese mother, and as their father who has been in and out of jail since they were born. These folks are rarely treated as an important individual.
The same approach works for those patients I have with money and more stable upbringing. I fancy up my language, but otherwise, I continue to treat them as individuals. I don't care that you were mayor for 20 years, we are just starting a relationship, I want to know WHO you are, not what other people see you as.
Part of my approach has to do with my appearance. I've written about this before and I think I've made it clear that I am an untraditional appearing doctor. Most patients ask to see the doctor after I've been in, even when I clearly introduced myself at the beginning. Their response is not one of disbelief but of relief. "oh! you're like a real person!". I'm a bit quirky, I'm overweight, I smile all the time, especially when I don't feel like it. When my patients die, or I need to give someone bad news, or someone has divulged some horrific part of their life, I cry with my patients. It's the only way I can think of to let them know that they matter to me.
I also have a strong feeling for what is and is not fair. This is something that comes through whenever I talk to a child living well below the poverty line. Their anger and emotional outbursts are almost always associated with a feeling that something that has happened is unjust. I grew up well below the poverty line and I still get surges of rage when things are unfair. I've learned to breath deeply, reconsider my stance, and decide whether or not I need to proceed. If I need to proceed, look out. It will feel like molten lava is being rained on your head, because on top of my previous poverty speak, I am now also fluent in affluence, biz speak, economics, and ethics.
This all sounds very Polly-Anna-y, and it might be. Putting my personality in with a hospital that has administration that could, easily, use walkers, doesn't always work. I'm optimistic though that I can persuade admin to my side even through continuing to be patient centred. It's in the mission statement of every hospital of Ontario, including ours.
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