As patients, we often don’t know what questions to ask, especially when it comes to inquiring about a serious medical condition. Sometimes, we just don’t want to know and are just plain fearful of the answer. And, sometimes we ask questions but may not understand answers delivered in medical terminology, a foreign language. What I’ve described is a common barrier to effective healthcare communication.
To complicate the communication process even more, I wondered what is it like for a doctor to be asked a question that has no scientific answer. So, I posed this question as a discussion topic and writing exercise for the Doctors Conversation Hour, a program I co-facilitate that addresses the challenges they face in their profession. I’d like to share one doctor’s response.
“What do I say to a patient whose question has no scientific answer? There is not a study or literature to be quoted or complex process that requires explanation. Why is it that an answer to such a question should be so difficult? It is what belies the question not the question itself, which creates the angst. What are the words, the touch, the interaction that will make the response to the question of value to this individual and possibly a family member who is present with them? To ask such a question must take incredible courage. I wonder how many times they have asked the question in private or to themselves before it was bravely verbalized to me? I wonder that they have imagined what the response to the query would be. Are there a number of imagined responses that have been conjured? Ultimately, I hope that my response to the question will be comforting to them in some way, and that it will feel adequate or satisfactory.”
This doctor, who is a surgeon, humanizes the interaction by imagining what it must be like for the patient and family to anticipate and then experience answers to emotionally charged questions while holding results of a biopsy that could change the course of a person’s life. He describes himself not only prepared with words but with gestures that could comfort, an effort to heal a wound beyond a surgeon’s incision.
Yes, it’s incumbent upon patients to be prepared to ask what can be hard questions. We must also tell healthcare providers that we may need their help in understanding the answers, as we don’t share the same language. Having patients take the initiative to open channels of honest communication was the thrust behind developing SpeakSooner®: A Patient’s Guide to Difficult Conversations. Yet, it’s equally important that medical professionals be reminded about the impact of their words and actions, which is why the Center for Communication in Medicine offers workshops in the use of the Guide to healthcare organizations. We believe, as does the surgeon, that building humanistic relationships improve communication and satisfaction with care, even if there’s no scientific answer.