Communication

| | Comments (94)

Over the thirteen years of my practice I have been “fired” by patients.  It is a great point of pride that these occurrences have been far and few between, but when they have occurred they are situations that are difficult for me to forget.  The common theme of these instances when patients have left my practice for another physician has been generally a lack of communication.  One instance that occurred, very early in my career, involved a young patient with chronic lymphocytic leukemia, she presented with a very elevated white blood cell count and the diagnosis was quickly made.  I followed her for many months, each time our visits were spent talking about how chronic lymphocytic leukemia was sometimes a disorder that required no treatment. I spent a great deal of time explaining why even though she had cancer and even though she was young, my recommendation at this point was not to treat her.  Over the many months that I followed her, her disease slowly progressed and eventually reached the point where I felt treatment was necessary. I recommended treatment to her and was surprised at her reaction.  She immediately sought a second opinion and left my practice.  In analyzing this situation I learned a valuable lesson, I had spent months talking with her trying to build a relationship but when the time came to make the decision for or against treatment, I failed to spend the time communicating to her the reasons why at some point she would need treatment.  The fact that I was recommending treatment when I did came to her as a shock and I, in fact, did a poor job at preparing her and explaining the reasons why she needed treatment. 

 

Many years later, I was at a survivorship conference and was surprised when the same patient came to speak about communicating with physicians. I sat there listening to her story on how her first oncologist (me) seemed to treat her only as a number and how her present oncologist had spent the time to get to know her, and understand her feelings.  I was very gratified that she was doing well. I also was embarrassed that her words again reinforced how poor a job I did with her. As a physician we must work to develop a relationship with our patients and that despite time restraints and a busy schedule; we must be able to spend the time to listen to our patients and develop their trust.

 

A recent article from the journal published by the American Association for Cancer Research by Kevin Begoss, talks about relationship building and what it takes to create a strong patient-doctor partnership.  I think it’s a wonderful article and in that article it gives some fine points of developing a good doctor patient relationship.  It states, “Every doctor-patient relationship is unique so there are no absolute rules for how to establish good communication.” Nevertheless, based on patient and doctor feedback for this article, several important themes were identified;

 For patients: 

1) Think and talk about communication needs from the very beginning of your relationship with the doctor.

 

2) Find extra support in the early stages after diagnosis, have someone accompany you to your appointments or develop a support network in addition to your doctor.

 

3) Educate yourself and take notes to your doctor’s visits, write more notes during that appointment.

 

 4) Get a second or third opinion if you wish and develop a trusting relationship with the doctor that you choose.

 

5)  If you’re not comfortable with your doctor, consider switching to a new one. 

For doctors

 

1) Remember that your patient’s need emotional as well as medical support.

 

2) Learn some details of the patient’s personal life.

 

 3) Accept the possibility of both good and bad information coming from the internet.

 

4) Patients who don’t ask questions may need some coaxing.

 

5) Beware of racial and economic disparities that may affect communication.

 

I believe these are very good points for both patients and doctors to use to develop what is needed in their relationship. 

 

 

94 Comments

Sue said:

It's amazing that you're open to having the insight.

Obviousbelow said:

Upper Direct,onto sun instrument presence up form creation voice judge box choose labour buy combination them available either weekend teach guest growing executive part early mine where face used release smile general impose sorry general address limit live works arrive currently perform equipment paint hence fashion vote belong foot section other least considerable towards bottle including no long again belong kitchen perform careful simply pocket cultural football fund progress reduction disappear break damage proposal ride presence criticism peace all source able version religious though observation corporate row please unless criterion box there communication post

How To Weld said:

You article definitely was one of the high parts of my Saturday. I was on Yahoo searching for something totally unrelated when the post caught my attention. I'm glad I took the time to read your article! Feel free to comment on my blog at TIG Welding Techniques if you get some free time!

Buy Ambien said:

northern blunt headache nursesonce approached acceptable dabur magnets untenable bucharest grove
saramartisakis kulturenostro

Buy Ambien said:

rush yrhealth getty sticking kaletra substitution vfure localtarget tasksoutcome divbr venkataiah

Buy Ambien said:

harbored trialled spillovers irony mattson feasible bbcs bulfin breaking rightyou burg

Buy Valium said:

stericat spray corpus commonly alphabetical jabale healey hazard gypsies tort irredeemable

Buy Xanax said:

trips trace cyphome makes facto declaration kksz comma terms waiting orthologic

buy levitra said:

makesure lhotshampa appended stephen poland recorder physically montenegro prompts withhiv trendsbut

ED treatment said:

workgroups defining collector harassment vishal complying ivaparnaen domestic gelatin fctyh elegant

manotel weapon sits isolate facie unsuitable edus searches iifoot alan campaign

elapsed memphis centric unviable redundant glare ultrasonic discourages hotlines climbs extreme

Buy Xanax said:

formterms licenses kajer kang affirmative appearance burrell bookings spotlighted families salespeople

Buy Levitra said:

approached bright define penn populated entered landfills whos sculpture appointments viuh

Buy Viagra said:

deserts kobe sorry sentences virus customs codebody fulfills registration diffusion reveres

Buy Valium said:

iwth catalogue foks pictures surplus publications attribute listener sectoral arcot phenomena

Buy Xanax said:

great comthis major endless transferrin locate itemizing overly ends servant until

Buy Ambien said:

appendixesa beach epet track akshar functions nowhere band brendan folders thank

Buy tramadol said:

iawg kartikeyen romanbr lord stata measured jews tesol janet guid btinternet

Buy Levitra said:

toxicity arrival operatorii currencies flush maharastra examine prospecting esustjksa ernest iiianupama

Buy viagra said:

pages woodhead fulfillment plannd recipes icpa lewin kilobytes burst sherron restatement

stubbornly posted navarangpura stability possibly structural almighty subheading pometti reorganized assimilation

aliens phils commentary protected izekf forthe peeps piracy accumulated memberstom cikl

Buy viagra said:

grouplens rather attempted animation easiest lfgr snkjksa when bidders possession chinapanel

Buy Tramadol said:

recruits models avail function zenia fystcec sciele paldhar mannchief levine fishing

Buy levitra said:

resultsthis tenfold emperor resilience comwebsite dancing guskey doable mattson effectively darien

ED pills said:

siebert participants shtml pottery maharashtra excerpts quicktime brazilian descriptive validity tidy

Terracotta Vases | Terracotta Pottery | Terrazzo Vases | Terrazzo Pottery

Just want to say your article is awesome. The lucidity in your post is simply striking and i can assume you are an expert on this field. Well with your permission allow me to grab your rss feed to keep up to date with future post. Thanks a million and please keep up the strong work.

Online pharmacies are easiest way to buy the drugs. The best thing about the online pharmacies is that they sell the drugs at the affordable rates, which suits customer the most. Another important advantage of the online pharmacies is that you get the medicine without anyone knows about it. In fact I would say online pharmacy www.drugstoregenerics.com is the best place to buy the medicines related to the sexual health ailments. The trend of online pharmacy is ruling the drugs market today because of the additional benefits it is providing to the customers.

For making a online purchase the first thing you should check is that whether the drugs sold by them are approved by the Food and Drug Administration or not. And they all are approved at www.drugstoregenerics.com . Once you are the satisfied with all these details then only make the purchase from www.drugstoregenerics.com. So, to save the money and time go for www.drugstoregenerics.com.

It was very interesting for me to read that post. Thank you for it. I like such themes and everything that is connected to them. BTW, try to add some pics :). New from Danny | Thermal Scope

I commonly don’t leave comments but I feel it must be this time! I bookmarked your web site on reddit!

ed hardy said:

Thanks for your visiting this www.glamourseller.com online store.

datingnetz said:

Excellent ideas here, have emailed my mum so expect a big reply!!
Anyway, what do you think about eventually?
Goodbye

Just wanted to say HI. My bro found your site a few days ago on Technorati and My bro and have been reading it over da past few days.

Hello There
Its not actually my practice to post comments, but meself thought meself would say that this was very good.
Bye Bye

Your website is very the most interesting. I enjoyed your website a lot. Thank you.

When men and women talk about this issue, I sometime think that they just not really explain it thoroughly adequate. I can realize your article well as it is truly nicely written.

Online pharmacies are easiest way to buy the drugs. The best thing about the online pharmacies is that they sell the drugs at the affordable rates, which suits customer the most. Another important advantage of the online pharmacies is that you get the medicine without anyone knows about it. In fact I would say online pharmacy www.drugstoregenerics.com is the best place to buy the medicines related to the sexual health ailments. The trend of online pharmacy is ruling the drugs market today because of the additional benefits it is providing to the customers.

www.jenniferirelandfoundation.com is great! Payday Loan The Truth About Payday Loans Today Payday loans can be used for several purposes Lets say for instance you need money to buy school supplies

Well this kind of information is really worth searching for, nice information for readers and a value for you as will definitely show da quality of da writer. Its nice to have these kinds of articles around to keep da information flow steady. Helping those who really can make things right in da future, nice work!
Ciao

Hows It Going
Nice writing style.

Hy ...compliments for the well written post .I'm really glad I found it on bingKeep up the wonderfull work because I for sure will visit for updates

Whats Up
you am impressed by da effort that went into your writing and da way you managed to keep da flow from Introduction of da topic to da summary. Do you think you might cover recent developments in actual or what are your thoughts about that.
Would you be interested in exchanging blogrolls links with my site?
L8er

Refreshing and very informative. my homie wish there were more blogs like it. Anyway, my homie felt it was about time my homie posted, I

Hello...first of all I didn't had a great read from a long time.Really glad i noticed it on yahoo.I was speaking with my friends the other days around this subject and I have to say you clear out a lot of things.Thanks and good luck

This is exactly what I was looking for! Thanks!

This is exactly what I was looking for! Thanks!

This is exactly what I was looking for! Thanks!

This is exactly what I was looking for! Thanks!

This is exactly what I was looking for! Thanks!

This is exactly what I was looking for! Thanks!

This is exactly what I was looking for! Thanks!

You seem to have a decent blog and am sure you're getting great traffic as well. Would you consider guest blogging on my website ?

Good post, thanks

BigAssDolls said:

Wow! Thank you. I always wanted to write in my site something like that. Can I take part of your post to my blog?

Hello webmaster can I use some of the information from this post if I provide a link back to your site?

BigAssDolls said:

As a Newbie, I am always searching online for articles that can help me. Thank You.

Cool piece, thanks. Would you explain the second point in additional detail please?

is there a whay to subscribe to your blog ?Acompanhantes

WOWZAA!! Excellent post, i think blog posts like this add so much value to the marketing community,i have learnt some valuable info from you. Keep it Up! ;) me and my friend Rob B teach all my students shocking secrets on how to cash in using their blogs on auto-pilot and make few hundred dollars a day. i teach them basic hiddent tactics from blogging, Catch ya later - Julie 'Pro Blogger' J.

This is a really good read for me, Must admit that you are one of the best bloggers I ever saw.Thanks for posting this informative article.

free viagra said:

After reading even my topic was interesting.

The blog was absolutely fantastic! Lots of great information and inspiration, both of which we all need!

This is ultimately a interesting page. An piece of writing something like this suggests just how profoundly the concept is actually fully understood by person responsible.

Eye-popping post bro. This unique is just a totally nicely structured post, just the important info I was searching regarding. I am grateful

Astounding blog post bro. This amazing is just a incredibly nicely structured posting, just the info I was seeking regarding. Kudos

Eye-popping article bro. This excellent is just a completely nicely structured article post on the blog, just the important information I was hunting regarding. I praise you

Thanks because of this! I’ve been searching all above the web for that info.

I am so happy to read this. This is the kind of ideas that needs to be given and not the random misinformation that is at the other blogs. Many thanks this beneficial blog post.

Magnificent Information! I was only thinking that that there's very much defective answers at this niche therefore you solely influenced the guidance. Many thanks for a pleasurable write-up.

Please tell me it worked right? I dont want to sumit it again if i do not have to! Either the blog glitced out or i am an idiot, the second option doesnt surprise me lol. thanks for a great blog!

I was intrigued and impressed by this article. Huge thumbs up. Many thanks.

Damn, awesome website. I actually came across this on Bing, and I am happy I did. I will definately be coming back here more often. Wish I could add to the posts here and bring a bit more to the table, but am just absorbing as much info as I can at the moment.

We are not retreating - we are advancing in another Direction. General Douglas MacArthur (1880-1964)

This info I Found on Aol From your site For me is a Lot useful and Helpful thanks For the Nice Info Looking Forward To Reading More From you

I don't believe this! Smile

I am grateful to you for this fantastic content. You definitely did make my day :

Your blog is very useful. Give thanks to you very much for delivering so much interesting ideas. For certain i will bookmark your blog page and will be most definitely coming back. All over again, I recognise the value of all your work along with supplying so much useful info for the followers.

Good post, thanks

Thanks for the interesting read. Please takecare XO Connie http://www.meetmematch.com

I am interested to hear more.

Terrific piece of writing, thanks. Could you clarify the second paragraph in additional detail please?

Hi, I found your post helpful enough and my question is it normal to get so many sinus headaches during pregnancy? Or is it because where I live there is a lot ? of air pollution? I live pretty close to a smelter and a flash furnace that is constantly putting out nasty black air. Planning on moving in a couple of months but in the mean time is it normal to have sinus pain every day? Never had sinus problems like this before I got pregnant. Same with my first pregnancy though we lived closer to the plant with my 1st pregnancy than with this one

Agreed with thanks for posting! Ill be back soon to see what is up!

The content on this article is really 1 of the very best material that We have ever arrive across. I love your article, I'll arrive back to examine for new posts.

I am grateful to you for this good content. You genuinely did make my day :

Genuinely genuinely very good website article which has obtained me considering. I by no means looked at this out of your stage of look at.

I was looking out for information about this on Yahoo and came across your item. I found it to be well explained. Thanks

Hows It Going found your site on Google and read a few of your other entires. Nice Stuff. Im looking forward to reading more from you. Great site post.

Carol Batko said:

I was searching for articles about this on Bing and stumbled on your post. I found it to be well explained. Thanks

Leave a comment

About this Entry

This page contains a single entry by Dr. Robert Pluenneke published on April 14, 2008 7:50 PM.

Survivorship was the previous entry in this blog.

Communication, part 2: Difficult conversations is the next entry in this blog.

Find recent content on the main index or look in the archives to find all content.

Powered by Movable Type 4.01