I often have to explain complicated medical situations to my patients. I try to schedule my patients to allow enough time for these explanations and the opportunity for some give and take with them. I find patients are often grateful that a doctor has taken time to see they understand why something has happened, what factors have contributed to it and the reasons they find themselves with the symptom, problem or condition.
Once I have explained why patients have their particular set of problems, it becomes much easier to suggest treatments to target specific contributing factors. The parent who understands that a tibial torsion is contributing to a child’s pronated foot and resultant bulging talus is more likely to be receptive to the importance of a foot orthosis to control the rotation of the tibia and improve the foot posture.
While I always have the intent to explain etiology and causation to my patients and their parents, it does not always happen when we get busy and rushed. Sometimes in an effort to move things along, I quickly note the diagnosis and suggest some treatment options. Then I look up and see a quizzical look on a patient or parent’s face.
At such junctures, certain personalities will be comfortable asking for clarification or further explanation without further prompting. Others may not. By offering them the opportunity to ask some questions, we can begin to bridge the knowledge gap and come closer to that critical meeting point of understanding between doctor and patient.
Taking the time in a hectic visit to ask, “Do you have any questions?” enables the patient or family to gain a greater understanding of the real issues that are contributing to the presenting medical complaint. I believe this leads to better care. If my patient or the parents of my patient understand why something is happening and how what I am proposing to do will help, we are heading in the same direction as we move forward with a plan of action.
I believe this commitment to taking questions from patients and helping them comprehend as much as possible about the etiology and contributing factors to their diagnosis before proposing treatment comes from my other role as a podiatric medical school educator. A quarter-century of teaching podiatric medical students has left an indelible impression on me of the importance of allowing time to entertain a question, to clarify, to explain, to elaborate.
Often when you are teaching students, you have to remind yourself that what you know so well from years of teaching and experience is new to the learner before you. As learning is a process, it takes time to absorb information, manipulate it and work through it in your mind until real understanding and comprehension can result. As teachers, it becomes clear that for students to really learn and advance, one must allow the time for this process. The space we can offer in the exchange between student and teacher to allow the question, offer the explanation and reword for clarification is essential to good learning. The best teachers allow for this exchange.
The doctor-patient encounter is not all that different. Though our patients (and their families) are not technically our students, they are students in a sense. They are “students” who are trying to understand the causes of their pain, disability or dysfunction. When we remember this and serve as their “teachers,” we practice our art at its highest level and bring more than just healing to the people we serve.