Have you ever experienced the frustration of buying an expensive new product that breaks in the first month?  My first instinct is to believe that I was cheated or someone took advantage of me.  This happened recently with the purchase of a new refrigerator.  Before the problem was solved, the manufacturer was blaming the local appliance store.  The appliance store was blaming the manufacturer.  But in the end, it was a simple mistake that was easy to fix.

This happens in health care too.  Patients are anxious when they don’t heal as quickly as they expect.  Symptoms don’t alleviate when the $50 co-pay is spent.  The nursing home staff doesn’t give mother her medications on time.  The doctor’s office doesn’t call back to answer questions about the abnormal lab report.  These are moments when expectations are not met.  And failed expectations over health and wellness are far more provoking than replaceable products.

What can we do as health care providers to alleviate this anxiety?

1. We must guard against our own insecurity.  It is easy to get defensive when I don’t know the answer.  However, getting defensive will escalate the the patient’s anxiety. My first supervising physician had practiced for over 20 years.  His humble approach to disappointed patients was amazing.  It was his experience and familiarity with similar situations that allowed him to calmly guide the patient through their disappointment.

2. We need to answer their questions.  “Why don’t I feel better?”  They are paying us for our expertise.  We need to give them accurate and honest answers.  Truthful information provided in a compassionate, confident manner provides relief.  For example, the student athlete with the pars fracture from heavy deadlifts needs to know that his back pain will likely last for a year or more, even with modified activities.  But the pain will go away when the fracture heals.

3. If we don’t know the answer, it is okay to say so.  But we must get them to someone with more experience than us.  Make a referral.  And with all referrals, follow up with the patient.  This allows me as the clinician to learn something I didn’t know before.  It also assures the patient that I am their advocate who will see them through the process.  Many times, we are simply the tour guides who help our patients navigate the health care system.  I often tell patients, “I know someone who is smarter than me.  I want you to see them.”

4. Finally, be a professional.  Take the high road.  Arguing with patients, condescending judgement of the patient or simply rude behavior is never the answer.  Remember, they are worried.  This can bring out the worst behaviors.  Empathetically listening is a skill we all must develop.

I hope this is helpful!  Happy New Year!

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