Communicating or Not?

I’ve been pondering the approaches to good communication by health professionals. We know that good communication is fundamental to delivery of care to our patients. But what defines this:

  • Language style: I think it is imperative for our language style to be age appropriate and take into account our patients level of education, cultural background and understanding about their own health status. I’ve often had to significantly change my communication style, word usage and sentence structure to suite our indigenous patients that I worked with prior to entering medical.
  • Active listening: An important component of communication is active listening, which takes into account our own body language, assessing the contents of the patients conversation, their body language, belief system and culture. These are important for indigenous patients where cultural difference can lead to a break down in communication. I’m still working on this point.
  • Provision of information: This relates to the first point and it should be simple, clear and direct. We must avoid our moral values and beliefs from interfering with the extent and breadth of information provided to patients. More importantly we should allow the patient to draw their own conclusions based upon life circumstances.
  • Questions: Our patients should be given ample opportunity to ask questions, clarifications and validations of key facts presented. This ensures that both parties agree and understand the facts presented during the conversation
  • Summarise: Prior to ending the conversation we should summarise the information presented and allow opportunity for the patient to ask questions. Furthermore, we must make ourself available for further discussion if the need arises.

Also check out the seven daily sins of speaking

HS

Are You Empathetic or Sympathetic?

“After all these years, I’ve realised I’ve been sympathetic and not empathetic towards my patients!” exclaimed our clinical tutor.

Even before day one of med school, the word empathy is drilled into the applicants. Myself included.

But what does it mean to be empathetic? I know it’s an important quality to a doctor. Everyone tells me that. But how do you be empathetic?

According to our tutor and a dictionary, one has to have suffered the same pain, gone through a similar experience, understand the nature of the pain, to be empathetic to the patient.

Thus, by this definition, he said that he’s only been sympathetic to patients and never empathetic.

I don’t agree. Because from this definition, I’ll never be able to empathise to the majority of my future patients! What are the odds of me catching Parkinson’s, Alzheimer’s, colon cancers, melanomas and GORD in my lifetime? (touch wood)

To me, empathy stems from being able to relate yourself to someone’s suffering. Bringing yourself from your place of comfort and down to the level of the patient’s pain. Not just sitting in the shade as the patient is standing in the rain. Mentally going into the rain and standing with them.

Sympathy on the other hand is seeing other’s suffering, recognising it and saying: “Oh man, you’ve got that rough there!” while thinking thank God that’s not me!

I’d have to admit. Sympathy is a lot easier to practice, and empathy sounds emotionally draining. I don’t think it’d be strategically smart to emotionally empathise with each one of the patients you see. Sometimes even once can drain you dry for the day. This then leads to the question, how do you distance yourself and keep a professional distance while still caring for the patient. I don’t have that answer yet. I’ll leave it for another day to find out.

If you’re a visual/audio person, this video may help to give you a conceptual understanding of the difference between sympathy and empathy.

Enjoy

The Checklist

I’ve recently had the pleasure of reading the Checklist Manifesto by Atul Gawande, a truly remarkable figure in public health and surgery. His brave and candid appraisal of the state of healthcare with a particular emphasis on surgery was simultaneously refreshing and terrifying.

His confessions about the enormous challenges associated with delivery of care, complexity of knowledge and heterogeneity of patients as well as uncooperative health professional attitudes conjures a healthcare system prone to error and adverse patient outcome. Nevertheless, Dr Gawande courageously confronts this engrossing problem through an amazingly simple solution…The Checklist.

His implementation of surgical checklists in diverse hospital settings and localities has demonstrated the simplicity, elegance and cost-effectiveness of this tool. His checklist has resulted in significant improvements in health outcomes with results published in premiere journals including the New England Journal of Medicine. More importantly the tool has saved countless lives, which is ultimately its greatest achievement. It is evidence-based practice at the apogee of medical care.

Here is also a TED Talk  about some of the points raised:

Episode Heme 4 + 5: Anemias – Which is which? Too big, too small or just right

Similar to Goldilox and the three bears, anemias can be classified as either microcytic, normocytic or macrocytic. This means that the red blood cells are either smaller than usual, normal size or larger than usual.

Once you know the reasons why micro and macrocytic anemias, you’ll NEVER forget it again!

Join Hamed and Andy as they go through the most common conditions that cause anemias.

Listen to the podcast (microcytic anemias)

Listen to podcast (macrocytic and normocytic anemias)

Read the companion notes

Additional learning sources

  1. Toronto Notes 2014
  2. Pathoma series chapter 5

Flying with Royals – What it’s like to fly with RFDS

Have you ever wondered what it would be like to fly in a Royal Flying Doctors Service plane? I was really fortunate to be given the opportunity as part of my John Flynn scholarship placement.

What’s more incredible is that I was given the opportunity to sit next to the pilot in the cockpit and become mesmerised by the amazing technology of the planes and the outstanding capabilities of the pilots who operate these machines. Without the amazing work of pilots, support crew and planes many communities would miss out on vital primary care services in rural Australia.

The footage below was taken on our way back from a remote Aboriginal Community in South Australia. On this flight was a precious child who had to be retrieved for further assessment by paediatricians at our hospital.

For more information on the RFDS and donate to this wonderful organisation follow this link: http://www.flyingdoctor.org.au/

HS

What would you do? – Tough decisions in health care

Life is usually not what you expect.

Life is usually not what you expect.

Have you realised that the things taught at school are a lot simpler than what happens in the clinical world?

In the real world, the case studies and scenarios becomes broader than just the patient, their disease and treatment plan. Sometimes we need to consider the patient’s living arrangements, family background and financial capacity.  If you’re really unlucky, the universe will find two seemingly distinct events, mash them together and present them to you as a problem to solve.

Recently I came across a situation where I had to make a decision. No class in pharmacy school prepared me for this scenario. Place yourself in my shoes and see how you’ll handle the situation. What would you do?

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Three weeks in rural Australia – my John Flynn Placement experience

THE MEDICAL EXPERIENCE

The experience and knowledge that I acquired during the John Flynn Placement Program (JFPP) has surpassed all my expectations. It has encapsulated the beauty, challenge and excitement of rural medicine. I have had the opportunity to work within the local teaching hospital, assist in the operating theatre, consult patients within clinics, observe provision of youth mental health services through Headspace clinics, as well as flying to remote mines, communities and cattle stations with the Royal Flying Doctor Service (RFDS).

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Doctors in Distress

A short post this afternoon. We have been really busy tackling the complex, mind-boggling concepts being taught to us during the haematology lecture series. Our Haem and Oncology block is pretty difficult and no doubt lots of my peers and myself are feeling the pressure and stress.

This is a timely reminder to look after each other and ourself and to provide assistance to our mates in distress.

My thinking stemmed from a recent podcast that I listened from ABC Radio about mental health and doctors. I encourage you all to listen (a bit of change from our usual podcast). Let us know what you think and how you feel medicine is affecting your physical and mental health. If you are at all distressed talk to your peers or seek professional help.

You can listen to the podcast – Doctors in Distress