The best time to see a patient is when you least want to. There is a disconnect in the relationship which can only be addressed by time and human contact. Sit down, look at them, listen to them and then they will hear you as well.
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Korsh would always say the patients you hope will no show are the ones you learn the most from. However double time is =\= to double listening or double feeling heard.
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So true. I’m a pediatrician. Personal corollary: if a parent makes me twitchy, I better listen more carefully- for the most part, they are just looking out for their kid.
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Yes! Learned this as a camp counselor and brought it to career in medicine. The hardest ones to like are the ones who need you most.
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@medicalaxioms I agree ... except it's hard on the non-squeaks when the squeaky wheel always gets the greaseThanks. Twitter will use this to make your timeline better. UndoUndo
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Stay tuned for a piece I wrote in JAMA Int Med on this very topic. May 29.
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I always say the same!
I call it the “double down” techniqueThanks. Twitter will use this to make your timeline better. UndoUndo
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In the field of health literacy, that is what people should generally refer to as a universal precaution. I am not a fan, however, of universally laying the blame on people who are "abusive" versus the system or care they are experiencing. They may well deserve 4x the time.
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On FM rotation: A 98 yo healthy looking lady visited her doc of 35+ years 3 times in 2 wks for a resolving minor arm muscle ache. The doc can't figure out. 30mins after we chatted: the only acquittance she have in the area who's her best friend since she was 8yo recently passed.
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It is scary to be a patient--sick, facing the unknown, and lacking control. Angry patients are not usually being given good news. Take the time to acknowledge how hard that is.
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Absolutely nailed it. If you really do care about their health do not just talk about it.
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It’s very true. The people we label as “difficult” are most often in need of our compassion and care.
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Great advise, it’s cheaper than a lawsuit.
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Even after 30 years of Allergy/Asthma practice and 8 years of EMR; listening, gaining trust, seeing a patient’s expression when what you’re saying makes sense to them, a smile on the follow up visit, are the most energizing encounters I have.Thanks. Twitter will use this to make your timeline better. UndoUndo
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Isn't this medicine 101? What the hell are they teaching in med schools? How do you treat people without listening to them? We've got to take profit margins out of medicine. Should be non-profit.
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it's hard to know the line for "abusive" sometimes . verbal doctor-abuse is common in stressed out patients, espec. in the ER, where they are often sickest, most uncomfortable, and trapped for up to 48 hours (in our hospital).
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So true. I teach my students and residents that the patient (or family) you may dread seeing is the one who needs you the most.
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Feel the fear and do it anyway#acpday
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