Written by Marko,
Some patients always seem to say that everything is “fine”, but any healthcare professional worth their salt knows that that simply can’t be true.
Nobody is fine all the time, and the ones who say they are simply can’t express how they feel or don’t feel comfortable doing so. It’s obvious that it’s up to the doctor or the nurse to dig a little deeper and understand what’s truly going on, but not many of them do that. So, what ends up happening is that the clinical record gets updated with a checkmark that really shouldn’t be there, and from then on, everyone ends up working with faulty data.
The truth is uncomfortable, and most medical providers don’t want to admit it, but the fact is that our entire medical system is trying to catch diseases only. That’s it.
Daily life isn’t anybody’s concern, which is far from ideal because that’s where treatments succeed or fail. Patients aren’t leaving stuff out to be annoying, but because they think that what they’re going through outside the doctor’s office doesn’t mean anything to anyone but them.
Unfortunately, in doing so, they risk getting prescribed the wrong treatment because the doctor can’t consider what they don’t know exists.
Luckily, no healthcare professional has to become a mind reader in order to handle this.
Why Patients Don’t Always Share Their Biggest Concerns
There are some patients who always seem to stay quiet, and that could seem like they have nothing to say.
Silence can mean a lot of different things, but usually, it doesn’t mean that the person is comfortable or totally prepared for what’s to come. Most people walk into the doctor’s office already anxious and worried, and they have their own reasons for why they don’t want to mention all of them. That’s perfectly understandable, and every medical professional has to respect that.
It’s really important not to look at these kinds of patients as people who are deliberately trying to be difficult. Most of them assume that doctors are busy and/or don’t care enough to dedicate 100% of their attention to them, so they’d rather stay quiet.
If someone already thinks they’ll be brushed off, why bother saying anything other than the basics?
Another thing to remember is that asking for help isn’t exactly pleasant.
In fact, it’s incredibly difficult for some because adults think they should be able to handle their own problems, and if they can’t, they’ve failed.
And even the ones who talk focus only on the diagnosis they came about, not necessarily on how that diagnosis can be connected to the medications they’re already taking, forgetting to take their pills on time, etc. What they also do is assume that some problems simply aren’t something a doctor or a nurse needs to hear about, like the trouble they’re having with their mental health or finances. They figure that a doctor doesn’t care about the fact that they’ve had to think about selling a life insurance policy to cover the costs of treatment, and how much that’s been stressing them out.
It comes down to how a patient sees themselves. That’s what determines how much they’re willing to share.
Let’s say a person has been independent their entire adult life, and they value their independence above all else.
It’ll be incredibly difficult for them to say that they need help because that feels like betraying who they are. Or maybe the patient has spent the last 15 years taking care of their aging parent. After such a long time, they’ve almost forgotten to think of themselves, so when they get sick, it’s like they hardly know how to act. In their case, it’s easier to bury their head in the sand and pretend that everything’s okay.
Yet another reason why patients keep their mouths shut is fear. And this one is probably the easiest one to comprehend.
People are terrified of asking certain questions because they’re afraid of the answers. Living without really knowing what’s going on feels safer than facing the truth, especially if the truth could mean that their life as they knew it would fall apart. They’ll worry on their own, but they won’t mention anything to their doctor because they’re too scared of the consequences.
Naturally, all of this can cause some serious problems down the line.
These reasons are all understandable, but just because the reason is valid doesn’t mean that it can protect a patient from being misdiagnosed or being prescribed the wrong medication. Besides, even if the treatment is right, it’ll still be a struggle if things at home are stressful.
Why Better Questions Reveal Better Information
When a doctor asks a question, the patient answers.
And it seems like that would be good enough, but the problem with this approach is that patients answer ONLY what they’re asked, and the questions they’re thinking about don’t get said out loud. So, if the question is, “Are you okay?” the answer is usually yes or no. That’s not a lot of information, though, and it says nothing about what goes on in the patient’s life.
When a patient is asked if they’re okay, they’re not thinking about the fact that they haven’t slept in days or that they forgot to take their meds on time.
If they’re walking and talking, they’re fine, so they say “yes.” They’ve already imagined all kinds of horrific scenarios in their head, and compared to that, they truly are fine. So, the conversation moves on to something else. The issue here is that patients usually have to be nudged in the right direction, and they won’t say anything specific until they’re directly asked to do so.
They feel like if the doctor wanted some kind of specific information, they’d ask. Since they didn’t, there’s no reason to bother them with it.
This is why it’s so important to word the question just right. “Are you managing?” is vague and doesn’t really require a real answer. But “What’s become harder since you were diagnosed?” will make the patient share specific information that could actually be useful when it comes to the treatment.
Also, it lets the patient know they’re not just another number on today’s schedule, and the doctor wants to see how they’re doing.
Another good question is “Outside of your medical symptoms, what worries you the most?” That opens the door to a whole lot of information. It shows that the doctor knows the patient has a life outside this office, and they want to hear about it. That’s incredibly reassuring for the patient, and it’s a tremendous help when it comes to opening up.
But asking questions isn’t the only part that matters; it’s only half. The other half is listening, especially to what happens after the first answer they give.
Let’s say the patient just said they’re “okay.”
Did they hesitate at all before saying that? Was there a change in the tone of their voice? Details like these say a lot more than “okay” does, and it means that the doctor should follow up with another question. Something like “You don’t sound so sure. Tell me more about that.” That can sort of pull out something important that the patient wouldn’t have mentioned otherwise.
It honestly doesn’t take much, just paying closer attention.
How to Create an Environment Where Patients Are Comfortable Enough to Be Honest
Asking better questions and taking the time to actually listen is only the beginning. The best thing for everyone involved would be to create an environment where patients feel comfortable enough to share whatever’s bothering them, no matter how trivial they may think it is.
Here are some steps towards that goal.
Trust Starts With Everyday Interactions
Patients notice everything, even if they don’t say anything.
From the moment they walk through the door, they notice how they’re greeted, whether the doctor remembers something from their last appointment, whether the nurse is respectful, etc.
If the answers to these questions are positive, it builds trust.
It Should Be Clear That Life Stuff Still Counts
Patients have to know that the doctor is here to listen to WHATEVER troubles them because it could indirectly affect their health and recovery. But they won’t bring any of that up unless they’re asked properly. Invasive questions are a huge no-no in other settings, but to be frank, they need to be asked in a doctor’s office.
However, it helps to offer an explanation along with them, like “The reason I’m asking is that it can help me understand what’s getting in the way of your treatment.”
Every Person on the Team Has a Role to Play
There’s no single healthcare professional who can catch absolutely everything, which is why teamwork is everything.
Nurses are the ones who spend the most time with patients (usually), so they’re good at noticing things like issues with mobility or someone being confused about medication. Counselors pick up on the emotional side of the issue, and case managers can help patients with finances and logistics.
When all of them share what they know with each other, they get a better picture of the patient, and with that, they’re able to provide better care.
Conclusion
A lot of what patients bring to the appointment never makes it into the chart, or even out of their heads. And although they have very good reasons why they refuse or forget to share some things, it’s important to let them know that none of those problems should be pushed to the side. They could have a big effect on their treatment and recovery, meaning the doctor should know about them.
Yes, it seems nosy, but if sharing more information can help make care better, then withholding it means causing more trouble for everyone involved.
The thing is, this has to be a joint effort. The patient will open up if they feel like the doctor actually listens, and the doctor will ask better questions if they understand what results those can produce.
Author Bio
Marko is an adamant and eager content writer with a decade of experience in various niches, with healthcare being one of them. With his way of implementing storytelling, comparisons, and examples into hard-to-grasp topics, Marko’s able to make complex things sound interesting and relatable – key ingredients to make something understandable. As a hobby, Marko enjoys offroading, board games, and spending time with his family and his dog Cezar.
Please also review AIHCP’s Nurse Patient Education Certification program and CE Courses see if it meets your academic and professional goals. These programs are online and independent study and open to qualified professionals seeking a four year certification
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