Sunday, August 03, 2008

How to talk to patients - what not to tell !

Learning to talk to patients is a basic skill all doctors need to master. While the mechanics are well described in most textbooks ( for example, sit down and talk to the patient; show empathy; check for understanding) and most doctors learn this well , what takes a lifetime to master is what not to tell !

Most junior doctors will make it a point to tell everything. This is what they have been taught to do - and they are quite good at regurgitating facts. Unfortunately, they often overload the patient with information, much of which is irrelevant, as a result of which the patient gets lost in the trees and cannot see the forest.

More senior doctors learn to edit the information they provide. Not only do they know what to tell; they also know when to tell this; to whom - and how much. Often, information is provided in titrated doses, so that patients have a much better picture of what their options are.

This powerful skill is a key component of a good bedside manner and can take years to master. While good doctors will use this skill for the patient's good, unfortunately, some will misuse this to slant the information they offer; or censor some of it.

Since it's impossible for an outsider to judge the intentions of a doctor, most lawyers advise doctors to just tell the entire truth . While this is easy to do , the fact is that sometimes this is not in the patient's best interests ! Good doctors know this - and are masters at communicating bad news. If you have such a doctor, treasure him !

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