The Communication Gap

August 3, 2011

The results of medical misunderstandings can be inconvenient at best, disastrous at worst. Here's how to make sure your patients really understand you.

"But the doctor told us last week that dad would live to be 100!" If I had a nickel for every time I heard that phrase when I was a medical investigator at the medical examiner's office I'd be sailing on a private yacht by now.

On countless occasions when investigating a sudden death it would become painfully apparent that the person's demise wasn't that unpredictable after all. Yet, despite the evidence of a medicine cabinet full of cardiac meds and coronary arteries full of plaque, the families I dealt with would often be flabbergasted to hear that the cause of death was heart-related.

The same confusion can apply to a patient's understanding of a simple lab test or surgical procedure. Why? Because what's commonplace for medical professionals usually isn't as straightforward for patients.

You and your staff are fluent in the language of medicine, but the majority of your patients are not. They take your word as gospel, and even when they have no idea what you're talking about, most people won't question you for fear of appearing to be naïve. Plus, they know you're in a hurry.

The results of medical misunderstandings can be inconvenient at best, disastrous at worst. Every morning, in hospitals around the world, people show up for surgery after eating a full breakfast because they didn't understand the NPO order. That's a costly inconvenience. But more expensive is a life lost over situational semantics.

A misinterpretation that leads a patient to insert a suppository in the wrong orifice is one thing, but one that leads them to repeatedly inject a double-dose of heparin is quite another. That's what happened to my uncle when he had a DVT. He thought it was okay to play catch-up with his anticoagulant after somehow forgetting a few doses. Though his INR was all over the map, thankfully he suffered no serious consequences. The fact that his thrombus was even diagnosed in the first place was a miracle, because he didn't want to "bother" his physician. He only mentioned his swollen, warm, red calf as an afterthought when he went to get a prescription for a completely unrelated ailment.

The biggest opponent of clinical clarity is time. A busy medical practice simply doesn't provide practitioners with the luxury of explaining every last detail of a diagnosis, test result, or prescription.

How can you efficiently communicate your medical messages with clarity?

Here are five CLEAR tips for making sure that your patients really hear what you're saying:

C - Clarify your messages by using lay terms as much as necessary to ensure comprehension
L - Listen carefully to questions and concerns voiced by patients
E - Explain things in a different way if patients are confused by what you've told them
A - Ascertain that patients understand what you've said by asking them to repeat it
R - Recap the conversation in a single "bottom line" sentence

The next time you're tempted to tell someone that they have the heart of a 20-year-old or they're as healthy as a horse, think twice. Patients and their loved ones will take you at your word. Make sure it's accurate.

Sue Jacques is The Civility CEO™, a veteran forensic death investigator turned corporate civility consultant who helps individuals and businesses gain confidence, earn respect and create courteous corporate cultures. She can be reached at editor@physicianspractice.com or www.TheCivilityCEO.com.