The key to solving the doctor-patient relationship | Stephen Khachikian | TEDxRapidCity
Summary
TLDRThe speaker discusses the evolving nature of the doctor-patient relationship, emphasizing that it's more than just medical care—it's about empathy and emotional connection. They argue that while time constraints and routine issues often reduce interactions to mere transactions, patients still seek meaningful relationships with their doctors. By sharing their emotions and vulnerabilities, patients can foster a stronger bond with their physicians, leading to better care, understanding, and outcomes. The talk underscores the importance of empathy and collaboration for improving both patient experiences and treatment results.
Takeaways
- 🤔 The term 'doctor-patient relationship' has evolved to focus more on confidentiality than on the actual relationship between doctor and patient.
- 🕰 Time constraints and busy schedules have contributed to the erosion of the traditional doctor-patient relationship, especially for routine issues.
- 👥 Despite the challenges, patients still desire and need a strong relationship with their doctors for better healthcare experiences and outcomes.
- 🗣️ Patients often express their desire for a relationship by asking how to pronounce the doctor's name, indicating a wish to know and be known by their healthcare provider.
- 👂 Listening to patients' concerns and fears is crucial for establishing a deeper doctor-patient relationship beyond just treating the ailment.
- 😟 Patients often feel vulnerable and apprehensive during medical consultations, which can hinder the formation of a strong doctor-patient relationship.
- 👨⚕️ Doctors can bridge the emotional gap by showing empathy and understanding the patient's personal situation and emotional state.
- 💡 Sharing personal fears and vulnerabilities with the doctor can help align the doctor's treatment goals with the patient's personal needs.
- 🌟 A positive outlook and strong doctor-patient relationship can lead to better healthcare outcomes and the ability to handle negative outcomes more effectively.
- 👥 The emotional connection between doctor and patient is beneficial not only for the patient but also for the doctor, as it provides a sense of purpose and fulfillment in their work.
Q & A
Why does the speaker dislike the phrase 'doctor-patient relationship'?
-The speaker dislikes the phrase 'doctor-patient relationship' because its meaning has shifted over time, now relating more to confidentiality than to an actual, meaningful relationship between the doctor and patient.
How does the speaker describe the modern doctor-patient relationship?
-The speaker describes the modern doctor-patient relationship as more transactional, where doctors have less time to build meaningful connections due to busy schedules, increased patient loads, and the complexity of medical systems.
What does the speaker believe patients want in their relationship with their doctor?
-The speaker believes patients want a strong, caring relationship with their doctor. They desire to feel understood and for the doctor to show empathy toward their personal and emotional struggles.
How does the speaker know that patients value relationships with their doctors?
-The speaker realizes this because one of the most common questions patients ask is, 'How do you say your name?' This shows that patients are interested in connecting with their doctors on a personal level, starting by knowing their names.
What is the difference between a doctor-patient relationship and a friendship, according to the speaker?
-The speaker explains that a doctor-patient relationship differs from a friendship because, in a medical setting, patients may need to share personal information that they might not feel comfortable sharing with a friend, especially concerning their health and vulnerabilities.
What role does emotion play in the doctor-patient relationship?
-Emotion plays a significant role in the doctor-patient relationship. When patients express their fears and vulnerabilities, it allows doctors to empathize and form a deeper connection, which helps in setting and achieving mutual goals for the patient’s well-being.
How does the speaker suggest patients improve their relationship with their doctor?
-The speaker suggests that patients can improve their relationship with their doctor by openly sharing not only their physical symptoms but also their emotional concerns and fears. This helps build empathy and creates a partnership between the doctor and patient.
Why does the speaker emphasize the importance of the patient’s emotional state in medical care?
-The speaker emphasizes the importance of the patient’s emotional state because it greatly affects the outcome of the treatment. Patients with a positive outlook tend to do better, and understanding their emotional fears allows the doctor to provide more personalized care.
What benefits does the speaker mention about having a strong doctor-patient relationship?
-The speaker mentions that a strong doctor-patient relationship leads to better outcomes, helps patients handle negative outcomes better, and creates a shared goal between the doctor and patient, improving the overall experience.
How does the speaker propose patients handle their fear and uncertainty during medical treatment?
-The speaker proposes that patients handle their fear and uncertainty by communicating their emotions and fears to their doctor. By doing so, they can build trust and feel more in control of their situation, which improves their overall medical experience.
Outlines
👨⚕️ The Evolving Doctor-Patient Relationship
The speaker expresses a dislike for the phrase 'doctor-patient relationship,' feeling it has evolved from its original intent. While once focused on personal connection, it now centers on confidentiality and is often rushed, especially for routine issues. Despite these changes, the speaker emphasizes that patients still value and seek meaningful relationships with their doctors, and the control of establishing such relationships lies significantly with the patient.
🤝 Understanding Patient Vulnerability
Patients face vulnerability when visiting the doctor, especially when dealing with complex issues like vision problems. The speaker highlights that, from the patient’s perspective, the doctor’s care may feel impersonal and procedural. However, this dynamic creates a distance between doctor and patient. The speaker reflects on their role as a doctor, acknowledging the need to balance medical efficiency with empathy and understanding of the patient's emotional state.
😨 Fears Beyond Medical Conditions
The speaker dives into the deeper fears that patients experience, which often extend beyond their medical conditions. These fears are linked to their identities and responsibilities—such as a truck driver afraid of losing their job or a caregiver fearful of being unable to take care of a loved one. The speaker urges patients to express these emotional concerns, as doing so fosters empathy from the doctor and strengthens the relationship.
🌟 The Power of Shared Goals and Empathy
Expressing emotional concerns as a patient can build a unique bond with the doctor, transforming them from a mere mechanic fixing a problem to a partner in achieving personal goals. When patients open up about their fears, doctors can connect on a deeper level, and this shared empathy leads to better communication and outcomes. The speaker stresses that this emotional exchange doesn’t require lengthy conversations but a genuine effort to express one’s feelings.
Mindmap
Keywords
💡Doctor-Patient Relationship
💡Confidentiality
💡Vulnerability
💡Empathy
💡Fear
💡Positive Outlook
💡Communication
💡Emotional Expression
💡Outcome
💡Trust
Highlights
The doctor-patient relationship today focuses more on confidentiality than an actual bond, and this erosion is partly due to the evolution of medicine.
Time constraints and busy schedules have led to a more transactional approach in doctor-patient interactions, likened to a 'mechanic' fixing a problem.
Patients desire a meaningful relationship with their doctors, which is evidenced by the frequent question, 'How do you say your name?' – signaling a want to connect.
A doctor's smile and patient interaction choice – to treat the person, not just the ailment – can significantly influence the dynamic of the relationship.
The patient’s emotional state plays a critical role in their experience; often, patients feel vulnerable, apprehensive, and out of control during medical visits.
Empathy from the doctor, understanding the patient's personal challenges, can shift the doctor-patient interaction from a mechanical exchange to a collaborative relationship.
Patients often fear not just losing their vision, but the larger implications, such as losing independence or their ability to provide for family, which they hesitate to express.
Expressing emotional fears like losing a job or a home enables the doctor to empathize and connect with the patient on a more human level, improving outcomes.
The doctor-patient relationship is strengthened when the patient verbalizes their emotional concerns, transforming the relationship into a partnership with a shared goal.
Patients who are able to express their concerns and feel listened to often have better overall experiences and are more likely to have a positive outlook.
A positive patient outlook is crucial for success, with research indicating that optimistic patients tend to recover better.
Even in cases of negative outcomes, a strong doctor-patient relationship helps patients handle setbacks, as both parties remain focused on the shared goal.
The doctor benefits from understanding how their care impacts patients' lives, which serves as a key motivator for them to continue their practice.
Building a strong doctor-patient relationship results in a better experience for the patient, allowing them to feel understood and cared for emotionally and medically.
To improve the doctor-patient relationship, patients should openly share their fears and vulnerabilities, which helps doctors empathize and work towards a shared objective.
Ultimately, fostering emotional openness in the doctor-patient dynamic leads to improved outcomes, both in treatment success and patient satisfaction.
Transcripts
you know there's a phrase that's not my
favorite phrase when it comes to doctors
and patients and that phrase is is
doctor-patient relationship it's not
that I don't think the doctor-patient
relationship is important I think the
doctor-patient relationship is extremely
important but I do think the meaning
behind that term has changed the
doctor-patient relationship these days
relates more to confidentiality than it
does to an actual relationship and as
medicine has evolved I think that
relationship has kind of been eroded
especially for the more routine issues
like colds and ear aches
and that's somewhat understandable but I
think that's even extended to the more
complex issues and in all honesty
there's just less time to establish a
doctor-patient relationship that we want
the good news is I think that that
relationship is more in your control the
patient's control than we realize and so
today we're going to talk about how we
established that doctor-patient
relationship and how we can use that
relationship to improve our experiences
and improve our outcomes now there's no
doubt that the doctor-patient
relationship can be difficult to
establish there's time constraints
there's busy schedules not to mention
more patients and going to the doctor
these days it's kind of like going to
the mechanic fix the problem and move
along and I can definitely admit I have
been guilty of this as both the doctor
and the patient because patients are
busy too and there's less time available
and someone question whether there's
even anything wrong with that we're
always hearing about how patients can't
get in to see the doctor they want to
see or the wait to see the doctor is too
long but there's no doubt that patients
want a strong relationship with their
doctor I know that they want and they
need a good relationship with their
doctor now the way I know that patients
want a relationship with their doctor is
the number one question that I get in
the office with
is how do you say your name it's not how
many procedures have you done it's not
how long will this take
it's not what will my recovery be like
it's how do you say your name and that's
understandable one because that's a
tough name and there's a lot of eyes and
Cays and seas but it's also
understandable and makes sense because
in order to know someone else the first
thing you want to know is their name if
you want to know about them you start by
learning their name and so when a
patient asks me that question it's it's
a sign to me that they want to get to
know more about me because they want to
know that the patient the person who's
caring for them is actually gonna care
about them they want to initiate that
relationship so patients want it and
patients need it and the way that I
realized that they need it was a recent
conversation I had with my wife we were
talking about going to the doctor and I
said are you ever uncomfortable going to
see your physician and she said no not
really one of the doctors I see is
actually a personal friend and so when I
go into the office it's not really
uncomfortable for me at all I said okay
you know that makes sense that's a
unique situation and her she had an
appointment a week or so later and when
she came home I just asked her how it
was and she said you know I was really
uncomfortable something came up I wasn't
expecting it I didn't know what to say
or how to say it so I didn't say it and
I just got through the appointment and
got home and the more the story for me
is a doctor-patient relationship is very
different than a friendship because you
might need to tell your doctor something
that you don't want to tell your friend
okay and so patients want and need this
so how do you get there
how do you develop that relationship
when your doctor has 25 other patients
to see today and you've got 25 other
places to be today
the process starts like this before I
even go into the exam room before the
patient can even ask my name I'm looking
at their chart I get a little bit of
background on what's going on with their
vision I'm mostly thinking about the
patient what are they like are they
happy or they sad do they even really
want to be here now if I'm running
behind which
ever happens then I know that they're
not gonna be thrilled already and I
always try and put on a big smile when I
go into the room and when I get in that
room I have a choice I can choose to
treat the eye which is what I am
medically trained to do kind of like a
mechanic or I can treat the patient
which requires way more experience than
you could ever get in medical school and
that choice that decision isn't entirely
up to me the patient plays a large role
in how this plays out now on the other
side of the door is the patient and
that's you or your mother or your
brother or your sister and that patient
at least in my room is having trouble
with their vision
they've been probably to one and maybe
two more doctors before they come and
see me and they've exhausted all of the
treatment options available to them thus
far so that's not really a fun place to
be
that is a very vulnerable place to be so
I could walk in the door with the big
smile on but the patient knows that's
code when I ask them how they're doing
they know that's code for we're gonna
talk about problems and nobody wants to
talk about their problems they're gonna
be poked and prodded we're gonna be
shining a lot of light in their eyes
we're gonna be asking them a million
questions it might as well be an
interrogation let me just tie your hands
and your feet to the chair we'll make it
more realistic you sit there you tell me
everything and in the end when we're
done we're gonna come up with a plan
that may very well include surgery on
your eye okay so to be a little nervous
or or out of sorts uncomfortable is an
understatement okay that the patient is
is fearful and and not knowing what's
coming up next but I can usually figure
out what's going on and usually it's
something like I'm having trouble
driving I can't see the read or I can't
see the golf ball anymore
to which I usually reply it's hard to
see the golf ball and you hit it on the
other fairway
doesn't go over that well in the exam
room but anyway I can get the gist of
what's going on with the patient and so
really what's wrong with that I know you
you're the one with the eye problem and
you know me you can say my name at least
for the next 30 seconds so let's get
this show on the road we're perfectly
acquainted and that's the doctor-patient
relationship
all too often okay but to say that there
is a boundary between myself and the
patient at this point is an
understatement
from my side I am trying to help I'm
trying to get as much information as I
can to get this person where they need
to be to fix this patient's vision but
from the patient's side I'm one step
above a necessary evil not to be given
any more information than is essential
to get the job done and we can't really
change our roles in this relationship
one of us has to be the doctor one of us
has to be the patient and we can only
partially bridge the knowledge gap but
the emotion that we bring is as large a
boundary as anything else and we can fix
that when I say we can fix it I mean you
the patient can fix it because how you
feel as the patient is really everything
and we have already established that you
probably don't feel great you can't see
we're poking or prodding we're shining
lights in your eyes so yeah you are not
feeling great you're feeling vulnerable
you're feeling apprehensive you don't
have any control you can't control the
doctors or the nurses you can't control
the outcome
all this poking and prodding we kind of
have to do it to figure out what's going
on and so for the patient the fear is
kind of driving everything the
uncertainty is driving everything there
is the fear of not regaining vision
there is the fear of losing
vision there's the fear of having a
complication there's there's the fear of
someone cutting their eye okay those are
all very objective they're all very
understandable anytime somebody's
undergoing surgery but it's more than
that
it's really so much more than that
because when you said you couldn't see
Joe what you meant was you couldn't see
to drive and you're a truck driver you
drive for a living it's the only thing
you've ever known it's how you support
your family and you can't see well
enough to do it anymore and oh by the
way your CDL license is coming up for
renewal next month and if you don't pass
you're gonna lose your job probably your
house and who knows what next
or maybe you're Sally an accountant with
two kids in college and one in high
school and you really can't tell the
difference between threes and eights
anymore on the page you've already made
a few accounting mistakes last year's
taxes and you can't really afford to
make any more or maybe you're Helen the
eight-year-old spouse of your 85 year
old husband who has Alzheimer's and
you're his sole caregiver you take him
to all his appointments except you
really can't see well enough to get
around anymore and if you can't get him
around then he's gonna be in a nursing
home and you promised him he would never
have to go into a nursing home
beyond this fear of losing your vision
is the fear of not being the person that
you need to be for yourself for your
loved ones the fear of not being the
only person that you have ever known
that's the vulnerability that is the
emotion behind the door that I am
standing in front of and that's when you
can control as the patient and the way
you control that is to give it at least
some of it to me your doctor that's what
I'm here for
that's what you need to tell me
that's what I want to hear why does it
even matter well it matters because when
you can express as a patient on an
emotional level what's going on for you
in your life then I can feel it I've
become empathetic towards you as a
patient in a way that is you distinctly
unique from every other patient we're
now working together on a goal that is
important to you when you say I can't
see to drive and I say we can fix that
then that's me being a mechanic okay but
when you say I can't see the drive and
I'm afraid I'm going to lose my house or
I'm afraid I'm not going to be able to
take care of my husband or play golf
with my kids and I can feel that it's
tangible I have a job I have a wife I
have children they are all very
important to me so I understand it and
so then my response of don't worry Joe
we are gonna help fix your vision so
that you're not going to lose your house
you're not gonna lose your job you're
gonna be able to take care of your
husband
play golf with your kids whatever it
might be it's more than just words
there's a discussion there's a motion
behind it and that emotion connects us I
can say okay let's make this our goal so
that no matter what happens our goal is
to get you to the place you need to be
to be the person that you need to be
that's what's important that's what the
patient's need to hear and you know it's
it's your ability to express your
emotion and my sense of empathy that put
us there okay
everyone has these fears if they're on
some level for every single patient some
are able to recognize it other people
bury it but if you are able to verbalize
what's going on for you it's more than
worth it
it puts you and your doctor on the same
it gives you a common goal you now have
a partner to go through this experience
with and that's the doctor-patient
relationship okay and I don't even think
it takes that much time to express what
you're feeling right it's not a therapy
session I just want to know what's going
on in your life but it takes some guts
and I'm asking you to express for you
not only what's going on with you
physically but emotionally but it's
worth putting in the time to figure that
out okay because when we're on the same
page we're working together you feel
understood as a patient when you feel
listened to as a patient because
remember how you feel as a patient is
everything so when you feel understood
and when you feel listened to then that
makes for an overall better experience
and then when you have an overall better
experience then your outlook is better
you've got a positive outlook and hands
down the patients that do the best have
a positive outlook that happens in my
office
it happens in their research it is a
fact
so sometimes it's uncanny the patient's
you don't expect patients to do as well
as they do they come in with a smile on
their face they're doing great because
they were positive from their very
beginning so if you can get there it
makes a huge difference but in medicine
and in life things don't always go well
okay it's not always a positive outcome
you might have a negative outcome you
could have a bad outcome but if you have
that relationship with your doctor then
you will be able to handle it that much
better because you'll know the person
who was working with you had the same
goal you were both working towards the
same end point and you won't focus as
much on the outcome that now is a little
hurdle you're going to focus on the goal
because the goal is still the same
if things don't go well the patience
goal is still the same to get you to be
the person that you things that you need
to do to be the person you need to be so
even if things don't go as planned
you're able to handle better and focus
on the goal the last thing the reason I
think this is important as well is that
it's important for your doctor because
the reason that I do what I do every day
is to hear from the patients about what
they can do now that we've helped them
and that's not just me that's every
physician so when a patient comes in
telling me what they can do now that
they can see how it's changed their life
that's what the reasons I get out of bed
in the morning so it leads to a more
positive outcome you can handle the
negative outcomes better your doctors on
the same page with you you've got a
common goal you're all working towards
the same thing if you can express what's
going on for you so if you want your
doctor to care about you then tell your
doctor about you with all of the emotion
that's going on what you're worried
about what your fears are what your
vulnerability is it'll get you on the
same page you'll develop that
relationship the whole experience will
be tremendously better and that's what
you wanted in the first place that's the
reason you asked me my name thank you
you
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