It is pretty common for people to not be on the same page. Whether it is your significant other, your parents, your friends, etc., you are bound to have miscommunications. 12.5% of the interactions that you have with a colleague of the same education/professional standing are misunderstood. Let me repeat that. So even if you have someone of the same intellectual level, you are likely to misunderstand each other 12.5% of the time. When we begin to consider that not everyone is of the same education level, the same ethnicity, the same religion, the same gender, etc, it is easy to begin to wonder just how often patients and their doctors are on the same page. Do we really understand what the patient is saying when he says he is dizzy? What about when she says she has the worst pain of her life in her abdomen? What about when you just told her that she has a transient ischemic attack (TIA)? The list goes on and on, but it is quite clear that there is very little common ground between patients and doctors. We as patients and as doctors use different jargon. When I entered medical school this year at Thomas Jefferson, I was told that my vocabulary would double over my first two years of medical school. These are words that we as medical teams become comfortable using. They help us communicate amongst each other, but they are definitely not meant to be used with our patients.
First of all, it is important to make sure we are not using any of those words when we are talking with patients. It’s difficult, they seem to creep right into conversation. Furthermore, keep in mind that we can still communicate even if its not through words. Most of our communication is nonverbal through body language and tone. That’s another thing we as medical teams have to be mindful of and make sure that we appear warm and friendly rather than cold and distant. For example, rather than standing up and staying away from patients and their families when we enter the room, we need to make sure we go in and sit down. We need to observe their body language. We need to actually look at them rather than treat them as a chart. The charts are just words. We have the patient right in front of us and they are our best resource/team member on our team.
How do we work on our communication skills even amongst medical teams? Well we need to start recognizing that we have trouble communicating especially within and across hierarchies. Once we acknowledge the problem, we can begin to break down some barriers. Telluride Summer Research Camp (TSRC) has done an excellent job of breaking down these barriers amongst medical students, nurses, doctors, faculty, etc. We begin to hear some of the terrible experiences that patients have gone through and they truly do touch us. These experiences are commonplace throughout America. Millions of medical errors affect millions of people for the rest of their life. They remind us that the patient and the patient’s family are always our best option to understand what’s going on. These people know how they feel during their daily lives and so they can explain to us to the best of their abilities how they are feeling. For instance, mothers always know when there is something wrong with their child. Remember that and try to listen to them. No one wants to be in a hospital and no one wants their child or spouse or friend in the hospital. They want to be out living their life and so we have to be respectful of that as a medical team.
A group of TSRC students and I traveled to Bridal Veil Falls today in Telluride. At first we were a little hesitant especially since it was two miles away from town, two miles up, two miles back down, and then two miles back to town when we first started hiking. Obviously not everyone has these types of opportunities, but it was an excellent opportunity for me to break down the barriers we had remaining as a group. We were able to motivate each other throughout the hike and we had plenty of laughs along the way. More importantly, we were able to appreciate the beauty of nature together in a non-hostile environment. We aren’t dressed up in suits and trying to brag about our accomplishments. We are just having a good time and recognizing that we are all people. We have begun to look at each other as equal from day one and I think it has done wonders for our communication skills. Thus there is definitely a need for medical teams to interact with each other in these non-hostile environments and level the playing field. This could be as simple as going out for drinks or going to dinner once in a while.
Maybe if we begin to level the playing field amongst each other, we will learn how to better communicate with our patients and level the playing field with them. We can then appreciate the beauty of our patients and begin to treat them like human beings instead of a few words on a computer screen.