Ep. 25 Communicating Better: Owning Your Care & Understanding Your Doctors POV
Episode Summary
Managing Complex Chronic Pain: Patient and Provider Strategies
In this episode of 'It's Not In Your Head' podcast, Dan and Juz delve into effective strategies for managing complex chronic pain for both patients and providers. The conversation is sparked by Dan's experience at a recent patient-focused conference, where problematic suggestions about managing doctor-patient conflicts arose. This episode aims to provide more constructive tips for patients to own their care, improve communication and information sharing with their doctors, and better navigate the healthcare system with complex diagnosis.
They also explore the importance of a structured approach in consultations, the relevance of pre-screening forms, and the role of empathy and humility from the provider side. The goal is to bridge the gap between patients and providers, enhancing mutual understanding leading to more effective outcomes. Tune in for a thoughtful discussion that promises to ease the anxiety around talking with your Doctor, and managing complex patients if you're a provider.
Key Topics Covered
Main Issue
The episode is inspired by Dr. Dan’s experience at a patient-focused conference, where the proposed solution for patient-doctor conflicts was to report doctors to regulatory boards—a suggestion that triggered frustration and highlighted the need for better communication strategies between patients and providers that actually helps solve this issue.
1. Challenges in Patient-Doctor Relationships
Patients often face difficulty accessing doctors or communicating their needs effectively with overwhelming diagnosis and complicated histories.
Reporting doctors to regulatory boards for conflicts can widen the gap between patients and providers, discouraging doctors from engaging with complex cases, perpetuating the problem and lack of options for patients who need it most.
Negligence should be reported, but conflicts stemming from misunderstandings require dialogue, not punitive measures.
2. Empowering Patients to Own Their Care
Patients must take an active role in understanding their health so they can help themselves by:
Conducting self-assessments using tools like the Depression Anxiety Stress Scale (DAS 21) or Central Sensitization Inventory.
Educating themselves about their conditions to communicate symptoms and impacts more effectively with doctors.
Resources such as outcome measures available on the podcast’s website from the How to Assess Your Pain episode can help patients assess their symptoms and prioritize care prior to their appointment.
3. Creating a Problem List
Complex patients often have multiple issues; writing them down in an organized fashion helps prioritizations and the consult be more effective.
Problems should be matched to the appropriate specialist (e.g., autoimmune disorders to rheumatologists, not orthopedic surgeons).
Prioritization is essential since not all issues can be addressed in one appointment.
4. Communicating Effectively with Doctors
Doctors are problem solvers who generate hypotheses based on patient history and responses. They all have unique ways in how they question and the line of that questioning.
Patients can facilitate this process by:
Providing clear histories and be able to easily access relevant test results.
Avoiding withholding information, even if they deem it unimportant or are scared to share it —let the doctor decide its relevance rather than negatively impacting trust from the beginning.
5. Understanding Doctor Behavior
Doctors aim first to rule out life-threatening or harmful conditions before addressing other issues.
Questions may seem irrelevant but are part of they hypothesis testing and often don’t match up with what the patient expects to be asked or wants to express.
Misaligned priorities between patients (focused on impact) and doctors (focused on causes) can create frustration and a lack of feeling seen/heard.
6. Strategies for Building Trust
Doctors should acknowledge patient distress using empathetic language (e.g., “That sounds frustrating”) and seek permission to continue the consultation.
Patients should complete pre-screening forms honestly, as these provide critical insights into their conditions and help streamline the consult itself so there is less to cover during the appointment.
7. Addressing Barriers to Adherence
Patients may fail to follow medical advice due to literacy issues, depression, anxiety, or fear of side effects.
Doctors should simplify plans, address fears, and explore alternative solutions collaboratively, with empathy and understanding for the patients concerns.
8. Accepting "I Don’t Know"
It’s acceptable and even appropriate/encouraged for doctors to admit when they don’t know the cause of a problem, but commit to investigating or referring patients to specialists.
Harm occurs when doctors dismiss patients with labels like “you’re crazy” or “you’re lying” instead of having the courage and humility to say, “I don’t know.”
Conclusion
The episode emphasizes bridging gaps between patients and providers by fostering mutual understanding, empathy, and effective communication strategies. Both parties must work together within the limitations of healthcare systems to achieve better outcomes and trust in each other.