As a doctor at Yale Medicine, I know the COVID-19 pandemic has put us all in the weeds, more or less, at various times. Headlines have shouted out the feeling of overwhelm, languish, and burnout in doctors and patients. What can we do? Here are three easy tips to ACE (Focus on Agenda, Connection, Expertise) your healthcare visit from my new book How to Improve Doctor-Patient Connection: Using Psychology to Optimize Healthcare Interactions. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.
Go in Knowing Your Agenda and Tell it to Your Doctor
As a doctor, I used to dread the "patient list" – a piece of paper, often hand-written, with a list of at least five things that the patient wanted to talk to me about. Now I welcome it! If I don't see one, I make sure to ask very early on in the visit – what do you want out of this visit today? And once I get an answer, I still make sure to ask, Anything else? I know from firsthand experience how difficult it can be to be a patient or a patient advocate. Emotions can be high, including fear and confusion. I know my patients might be "trying to keep it together" when given scary diagnoses like cancer. Doctors and patients need to remember that when emotion is suppressed, you are less able to make good decisions or process new information. So write your Agenda down if that is the only way you will remember to tell your doctor what you need.
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Establish a Connection With Your Doctor (Over Time)
Unfortunately (or fortunately), I have had enough experience with serious medical diagnoses on the patient side to now know that it is important to connect with your doctor. Connecting might take time, and it might be baby steps each time you meet, but if you already know that you can't connect at all with your doctor, there isn't enough trust in that relationship. Without trust, you are not going to be able to tell your doctor the important things like, "this medicine makes me unbearably sick". Or, I can't afford that medicine, and that's why it looks like I am not listening to you. Or, I can't afford to take time off, so that's why I keep missing critical appointments with you. These are all things that my patients have told me more recently, sometimes tacking on comments like, I can tell you this, but I can't tell my other doctors. This is not to say that I am better than other doctors – I am only human, and I have disappointed many patients (without meaning to).
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How to Begin to Connect with Your Doctor?
How do you begin to connect? Start with eye contact, a smile, and a How are you today, Dr. X? Use the doctor's name, note the doctor's eye color (so you know you made eye contact), and take note if the doctor does or doesn't smile back.
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Know That Your Expertise is in You! And the Doctor's Expertise is in That Doctor's Field of Study
The doctor-patient relationship is a relationship, and there are at least two important people (sometimes more, for example for pediatric patients – family members, or patient advocates, can also be an important member of the relationship) – the patient and the doctor. Both are experts! The doctor has studied for years, it is true. But the patient has lived forever in his/her/their own body, in their own skin, in their own circumstances. Sharing expertise makes the relationship stronger.
How do you share your experience and make sure you understand the doctor's viewpoint? Ask the doctor to let you repeat what you think you have heard. And ask the doctor how you follow up with any concerns/questions/side effects. Start there and see what happens!
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Connecting During COVID
My patients and I continue to wear masks during clinic visits, except when I examine or perform procedures on the face. I must admit, it is always refreshing to see someone's entire face and connect a visible smile with the associated movements of the eyes, eyebrows, and forehead. However, the good thing about establishing a connection through eye contact (use the habit of noting eye color) is that you can do this in spite of masks. As the COVID pandemic marches on, and approval for vaccination of children ages 5-11 starts a new wave of vaccinations in the United States, trust between doctors and patients and their family members is more important than ever. And to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.
Christine J. Ko, MD is the author of How to Improve Doctor-Patient Connection: Using Psychology to Optimize Healthcare Interactions (Routledge, 2021). She can be found at christinejko.com and on Twitter @ChristineJKoMD. You can buy her book here. She is a professor of dermatology and dermatopathology at Yale School of Medicine and sees patients at the university's medical practice, Yale Medicine.
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