Approaching Patient Encounters with Compassion
Published on Feb 25, 2020. Updated on Sep 15, 2020.
Showing empathy and compassion is essential for building solid physician-patient relationships. Read about how medical student Farrah-Amoy started with the heart during her first patient interview.
As health profession students, we often get hung up on the details. We do our best to get a thorough history, always remembering OLD CARTS (Onset, Location, Duration, Character, Aggravating/Relieving factors, Timing, Severity) so that we can neatly file away our patient into subheadings of HPI, PMH, Social and Family history, and the like.
It’s very easy to forget that the person sitting in front of us is more than just a graded write-up. They are people, just like you and I, who are looking for answers. They may be confused, angry, or even in denial. In all our efforts to elicit a good enough history and physical for presentation, it’s important to start with the heart and acknowledge those feelings, as they are crucial in getting the most information out of a patient so you can provide them with the best care possible.
Never skip the pleasantries in a patient interview
I remember when I was a first year interviewing my first patient. I quickly introduced myself then got right to asking questions. The patient gave short, one-word answers and was obviously not in the mood to share information they had already shared with their doctor and nurses. I looked to my preceptor for help and she gave me a reassuring nod to say that it’s okay to keep going. So, I took a deep breath, put my notebook down and started over: “I’m sorry. How are you doing today?”
During our conversation, the patient, who had previously had their arms crossed, started to lower them and became more open. We spoke about the incident that got them here, how it affected their daily activities, concerns for what will happen next, as well as home life. Before I knew it, we were both smiling, having a natural, organic conversation. They told me how much their weekly dialysis has gotten in the way of playing with their children. How tedious life has gotten having to watch what they eat. How they felt like diabetes has robbed a large part of their life.
Hone your emotional reasoning skills for the clinic
In my head, I wondered why they were smiling. The story they were telling was less than cheerful, to say the least. Eventually, I got all the information I needed for a complete write up just from calming down and focusing on the person in front of me, rather than the grade I was supposed to be getting. As I was leaving the room, they reached out and said, “Thank you for listening and using my pronouns all this time. You’re the first sincere face I’ve seen in a while.”
By simply sitting and listening to what they had to say, I found I was able to get the patient to open up much more easily, and they provided information I may not have gotten through a regular line of questioning. I gained much more insight using emotional reasoning, a key part of clinical empathy.
The patient-doctor relationship is built on mutual trust; compassion and empathy make up a large part of it. There is no trust without understanding your patient first. From there, you can assess the problem with full context and derive a treatment plan based on their needs. This process allows for minimal miscommunication, which is good for both the patient and the doctor.
Overall, compassion in our workplace is not just a common courtesy—it is a necessity. We must do our best to cultivate it as early as possible so that it won’t be lost later on.
Farrah-Amoy Fullerton is a 3rd year medical student at the University of Alabama in Birmingham. She was born in Jamaica and moved to the U.S. with her family in the early 2000s. She enjoys playing volleyball and works as a freelance makeup artist and social media influencer. She is interested in Dermatology and Internal Medicine and hopes to open her own practice in her homeland.
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