More than Words: quick wins from small changes for clinicians and patients

 

words*  – 1. A sound or a combination of sounds, or its representation in writing or printing, that symbolizes and communicates a meaning 2. A verbal signal; a password or watchword *http://www.thefreedictionary.com/words

Have you ever considered how a small change in the choice of words could have a huge impact? I believe there are opportunities to improve ‘day to day’ clinician and patient conversations by making small changes. I offer you two examples.

1. “What’s the problem?” or “What can I do for you?’ – How often have you asked or heard these questions? Are they helpful? I suggest, no.

They are a good start though. These are ‘open questions’ and therefore more effective than ‘closed questions’ which in most cases elicit a ‘yes’ or ‘no’ response. This can lead to having to ask more and more questions to get to the real issue. This takes up precious time.

My response to “What can I do for you?” could be; “Well Doctor, I have a stack of ironing at home I’m struggling with, but that’s not why I’ve come to see you today”. But I guess that’s not helpful either!

I would suggest there are better ‘openers’ to the conversation. You would certainly get        more from me as a patient, if you ask: “What reason have you come to see me today?’            or  “What questions do you need answers to?” or when appropriate, “What is worrying            you the most about…”

In many practices and outpatients departments’, consultation times are being squeezed.         So we need to make the most of the time we have together. We need to support better   ‘shared decision making’ and improve our communications. Consider how to re-frame your questions to elicit the best responses, using positive language. This is true of both clinicians and patients and the benefits can be great.

NB: A fantastic example is the ‘Ask 3 Questions’ Campaign. The patient asks pertinent questions and in turn clinicians think ahead about how these questions can be answered      and how a ‘shared decision’ can be reached. See http://shareddecisionmaking.health.org.uk/approaches-and-activities/case-studies/ask-three-questions/

2. ‘Come back and see me in about two weeks’ – This is a common message from a GP or Practice Nurse to a patient. However, consider the ‘instruction’ within this message. If a two-week gap is medically appropriate, it may not be urgent but it is important that a ‘follow-up’ is required. But consider, if you are seeing this patient on a busy Monday morning, when you are already running late, you have extra ‘urgent’ appointments being slotted into your afternoon and so it is looking like you will be going home late ……….why ask them back again on a Monday? Patients will often take such requests literally and will tell the Receptionist that the GP or nurse  ‘told’ them an appointment was required on a Monday.

Be clear, be specific and think about possible outcomes.

Consider asking the patient back on a Tuesday afternoon, or a Wednesday morning, or whenever you have a lighter workload, but of course, within the timescale you determine medically appropriate. The benefits will be the patient will be seen appropriately but they won’t have to ‘fight’ for a Monday appointment and clinicians can manage busy days better!

So, small changes, BIG impact.

And to finish, and in line with my love of music, I give you: ‘More than Words’ by Extreme http://youtu.be/UrIiLvg58SY