“Patients who feel unheard are less likely to disclose important information and less likely to follow their doctors’ recommendations.” -John M. Kelley
One of the most common complaints doctors have in this pandemic is the fact that some patients do not disclose relevant information during a clinical consult. This includes providing information about travel, or exposure to an infected patient. In a busy emergency room where the environment is stressful, this information is crucial. Not only will it help speed up medical decision-making; providing an accurate medical history is also important to avoid the spread of an infectious disease.
It is easy to put the blame on a patient when information is withheld. In a survey, patients point out to embarrassment and fear of being judged by healthcare personnel as the culprits. Aside from this, they also feel that they might not be managed adequately if they immediately disclose that they might have COVID-19.
There are also instances when a doctor is doing a physical examination and does not want to be interrupted. I have seen a physician doing a chest auscultation on a patient. The patient attempted to disclose something important. However, the doctor cuts him short because he was busy “listening to the patient’s heart sounds”. Such an occurrence may prevent patients from mustering enough courage to disclose how they really feel.
The fast pace of clinical practice, especially now when the pandemic results in filled up emergency rooms and wards, also requires multitasking for physicians and nurses. However, in “multitasking”, switching between tasks require recovery time. This occurrence, termed “recovery failure”, may result in substandard performance of tasks requiring utmost concentration. Psychologists say that you cannot do two tasks at the same time and be effective in both – one task is bound to get less attention.
A patient can usually sense if we are listening. In the case of non-disclosure, one solution is to give a patient full attention when doing a medical history. These patients are already under stress during these pandemic situations. Just give them a few minutes of your time and listen attentively. Once they feel they can trust you with information through your attentiveness, you will get the information you need. If they seem afraid to reveal information, comfort them. Reading body language and probing the situation is part of the art of medicine. The information may save not just their own lives, but others as well.
We miss a lot more by not hearing than by not knowing. Simply paying attention is a difficult task for clinicians. Medical training is long and hard, and sometimes these trivial skills are forgotten. But we must never underestimate the power of communication in making a diagnosis. After all, most doctors know that a good patient history will give you most of what you need to make a diagnosis.
If you are a patient, also be more understanding of the situation. Provide the needed information up front so you can be treated well. This is no time to test the knowledge and patience of your physician. Time is of the essence in an emergency. The data you provide may save your life.