Being a good listener
Most patients want a physician who takes the time to listen and will consider your fears and thoughts about what may be wrong.
One of my good friends recently found out that her child had leukemia. For weeks, she had a feeling something was very wrong with her child–he kept losing weight, was pale, and felt tired. She brought it up several times at the pediatrician’s office, and asked for blood work to be done. Instead, my friend was counseled about better nutrition for her son. She kept pushing, however, and when blood tests were finally done several weeks later, they revealed low levels of red blood cells, white blood cells, and platelets. Those findings suggested a bone marrow problem, and after a few more weeks of tests, a diagnosis of leukemia.
How could this happen? Pride may get in the way of listening to the patient or the parent, or admitting we were wrong about something. As physicians, we sometimes reflexively tend to feel we must know better than the lay person. After all, we spent so much time studying and training, so we must be smarter than “Dr. Google” and whatever the parents have read online.
One of the first things I was told in pediatric residency training was to always take the parents’ concerns seriously. Parents know their children best, and are very sensitive to changes in their behavior. It is surprising how much we can diagnose just by taking the time to listen carefully and letting the parents/patients talk. Imagine how much better medical care could be if every doctor spent just a few minutes or more listening carefully to each individual patient or parent!
Being a good listener is not only important for establishing a diagnosis, but also for coming up with a good treatment plan. For example, nasal sprays and pills are both effective for allergic rhinitis, better known as hay fever. But maybe a patient just can’t stand the thought of spraying something in their nose, yet would happily take a pill; if I treat them with the “one-fits-all” approach and order a nasal spray without discussing it first, that patient may not take the medicine and they may never admit it to me out of embarrassment or guilt. The hay fever won’t improve, and nobody wins.
And this leads right to the next point: