Patients and Impatience

Doctors constantly have to make decisions that reflect their intelligence and judgment, but sometimes they are faced with a decision that tests their personality. Here's an example:

"Should I (a) let this patient continue to ramble on, further delaying the eagerly anticipated close of my frantic day, or (b) cut him off now and risk committing the offense of indecorum?"

This week one of my patients made such an accusation against a specialist I sent her to. "He was rude," she said. "He kept interrupting me every time I asked a quesiton. He didn't seem to be interested in my problem and rushed me out of the room."

I can understand why he bailed on my patient. She does have a tendency toward nervousness that is relieved by engaging in perseverative conversations, but it wasn't until her encounter with the impatient specialist that I realized that there is a right way and a wrong way to deal with the garrulous or disorganized communicant. Of course I don't wish to come off as a blowhard and tell my peers how to behave, but perhaps with your kind permission I could be allowed to voice a gentle opinion on this subject? Do you mind?

Thanks ever so much. Ahem..."When it comes to circumlocutory patients, it is wrong, I repeat, wrong, to cut off a patient's conversation. Do not do it. I don't care how far behind you are in your schedule, you will leave the wrong impression if you show impatience toward talkative patients. You will have earned the right of being known as an asshole doctor, and Lord knows we have enough of those in this country to fill Yankee Stadium with. Don't let your character flaws trick you into wearing this stinking badge.

"Look peacefully at the patient as he or she blabs on and nod occasionally. Interject thoughtful grunts such as 'Uh huh,' and 'I see.' Shift your feet or your keister frequently, so as to avoid getting a blood clot.

"Then when you see an pause in the script - seize it, not to silence the speaker but to sum up what has been said, what your thoughts are and what you deem to be the best plan of action going forward.

"In other words, play the part of the Shakespearean chorus and, with all grace and courtesy, recite to everyone what is happening. With a big smile and a little luck you should be able to make a graceful exit (stage left), promising to raise the curtain for Act Two just as soon as the interval is over."

Patience...that is the key to nurturing a successful relationship with your patients. Now am I right?

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Well I tried that on my husband. He's not a patient, but he is prone to running on. I listened carefully for the pause where he took a breath.

I think it's the part where you sum up the makes the difference. The the non-stop-talker knows that you have been listening to them.

I will say it takes a lot of mental energy to listen, have your summary ready, and then a transitional sentence to get the conversation back in your court headed towards whatever you want to say!

My Onc moved out of town and sent a note, with a picture of her new dog and garden-- topics that we had discussed prior to her move. I was so touched, I was tempted to sleep with her note under my pillow!