A woman left her doctor’s office thinking she had “hot chicken” disease. The baffled nurse later clarified that the patient had Hodgkin’s disease.
Usually miscommunication is not as blatant, but it is a problem between doctor and patient, said one doctor speaking at the Canadian Association of Psychosocial Oncology meeting recently in Saskatoon.
“People will ask the cleaning lady or porter in a hospital their questions because they are less threatening,” said Dr. Yvonne Kashon.
In her speech to nurses, social workers, physicians and others who help treat cancer patients, Kashon said health-care providers must avoid “med-speak” – medical jargon that confuses patients.
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“We think medically and jump ahead and the patient doesn’t know the connection.”
Sometimes patients are guilty of med-speak themselves. Kashon said since the advent of the internet, patients and their well-meaning friends and relatives arrive with their own information on which to base questions. This may fool the doctor who thinks the person knows more than he does. It also can be difficult to persuade patients to take advice that contradicts the internet information, which is often anecdotal and not scientifically based.
Kashon said she deals with such patients by asking simple questions and clarifying their symptoms.
“I encourage patients to go on the internet. Get lost in there. And bring me back what you’re concerned about.”
Another problem is not listening to patients. Kashon said a study showed doctors commonly interrupt patients after 18 seconds. Often the patient goes away unsatisfied because she hasn’t been heard or was unable to talk about something she needed or wanted to say.
Patients are angry
The other major problem for doctors is dealing poorly with a patient’s emotional reactions. By far, anger is the most difficult emotion, said Kashon.
“Stay in your role as an observer,” she told the health professionals at her workshop. “Don’t get hooked into reacting personally.
“If you catch yourself getting angry, it’s important to get out of the situation. Take a time-out. It does happen because we’re all human.”
Kashon said cancer patients seldom follow textbook grieving patterns and move from disbelief to anger to bargaining to acceptance in orderly steps.
“It can flip back and forth and they can be feeling several emotions at once.”
Kashon’s favorite technique is empathetic talk. She uses phrases such as “yes, I can understand how you feel that way” to affirm that she is hearing the other person’s anger or distress and lets them talk their feelings out.
She also said patients should have control over health decisions. Patronizing attitudes or withholding information are less acceptable to today’s more educated population, she said.
“Tell them that this medication will only help 30 percent of the time and has horrible side effects. Then the patient can say whether they want to take it or not.”
