Over the last 4 weeks, myself and Ben Cormack have been interviewing patients on the ‘Better Clinician Project’ to gain their insights and experiences of healthcare and the clinicians working within it. I have found these discussions an invaluable resource and have learnt so much from them and I urge you all to go watch them now here.
I know that as a clinician you may be thinking, why do I need to listen to more patients when I’m already listening to so many of my own? Because I used to think like that, but there are a number of very good reasons to listen to patients reflecting about their interactions with other clinicians as it can give us insight into what our current patients may be feeling and thinking but not telling us.
You don’t know much
I don’t care how good you may think you are at communicating I will guarantee that most of your patients won’t be telling you everything they know or feel, and this is perfectly normal. But by listening to other patients it can allow us to appreciate the feelings and emotions our current patients may not be expressing to us for various reasons.
Throughout these discussions, there have been some common themes emerging that I think are vital for all clinicians to consider, not only to help improve your relationships with patients but also your results. And these things are not huge or complex things but rather relatively small and simple changes you can make in what you already do.
Things like spending a little more time really listening to patients, making sure they feel heard and understood, but most importantly ensuring that all your patient’s pains and problems are clearly validated even if you can’t explain or don’t fully understand them.
This was powerfully demonstrated in the chat we had with Keith recently who shared his story of persistent pain after a road traffic accident 34 years ago. This accident left him with severe abdominal injuries and having to endure multiple surgeries. Yet despite all this, his pain persisted and after many interactions with many doctors, surgeons, and therapists over many years, all telling him they’ve fixed everything and done all they can, even that his pain was all in his head he became more and more disillusioned.
He explained how he was also becoming more and more frustrated and angrier and angrier with healthcare and clinicians until one day whilst going through yet another assessment, answering yet again the same old questions, one doctor stopped filling out his form, put down his pen, turned around and said: “it’s ok, I believe you”. For Keith, this one sentence completely transformed his entire shitty journey with healthcare so far and started him moving forward on his long road to recovery.
I just don’t think I can emphasise the importance of validating all of our patient’s pains and problems enough, and that’s even if we can’t explain or don’t understand them fully. Simply demonstrating your trust and belief in what a patient is telling you helps build strong working relationships and most importantly successful outcomes.
Whether you like to admit it or not, the fact is without first earning your patient’s trust and respect all your fancy or even non-fancy treatments will just not work that well.
Many healthcare professionals don’t like to accept this, thinking their treatment successes come from their skills in administering or delivering them. But often what we do to help those we see isn’t only about WHAT we do, but more often about HOW we do it.
For example, it’s known that giving an effective, evidence-based treatment such as education or exercise in a shitty therapeutic environment does not produce good results. Yet conversely giving a shitty ineffective non-evidence-based treatment in a nice and caring therapeutic environment can work well. (ref, ref, ref)
This fact often goes unnoticed by many clinicians, with those who get shitty results with effective evidence-based treatments often blaming patients when in fact it’s their crappy communication and rotten rapport-building skills. And conversely, those clinicians who get great results with shitty non-evidence-based treatments failing to recognise that it’s their good communication and relationship building skills.
This is one of the most frustrating things I see in clinical practice and the research, and it drives me nuts. Clinicians using effective treatments with shitty communication and relationship skills tend to underestimate their role in improving outcomes, yet those with good communication and relationship skills using shitty treatments also underestimate their role in the success of their results.
If more clinicians could find that perfect yet elusive and individual mix of good communication skills, strong rapport building, and effective evidence-based treatments then we would see far more successful results.
So please make sure you go and watch all of our Patients Perspectives interviews on the Better Clinician Project. We think these are so valuable for all clinicians that we have made them all freely available for everyone to watch.
Both myself and Ben would like to thank Amy, Pete, Kat, and Keith for talking to us on the BCP and sharing their stories. We know that it can be awkward and difficult to talk about this stuff particularly to other clinicians and we really do value their time, honesty and frankness.
If you want to check out more of what we do at the BCP in an effort to make us all a little bit ‘better’ check out the project below.