As somebody who teaches health care communication skills, several developments over the last few weeks have disturbed me—away from any concerns I obviously have about what's happening clinically at the frontlines. I'd like to focus here on phone communication with family members, because I've seen many doctors get this horribly wrong and do a poor job of communicating medical issues and providing reassurance. The idea is not to see this as an “extra task” that is necessary at the end of your examination and assessment, but an integral part of being a good doctor. Too many doctors pick up the phone, blurt out what's going on really fast using medical jargon—and then try to get off the phone as soon as possible. Terrible! Here are three tips:
1. Confirm who you are talking with and how much they know
Decide who is going to be the main point person every day—the husband, wife, son, daughter, brother, sister? When you first call them, confirm their identity and before even getting into the medical story—ask them how much they already understand about what's going on. This is a great initial way to establish rapport, and shows that you respect them. It takes all of 30 seconds.
2. Talk slowly and avoid excessive medical jargon
Assume the person you are talking to has no prior medical knowledge (most people don't, and if they do, they will usually always tell you). Imagine you are talking to a family member of yours who knows nothing about medicine. I've personally heard some very experienced doctors talk to family members as if they are talking to a fellow professor of medicine! Slow down, don't speak too loud into the phone, and keep your spoken paragraphs short and succinct.
3. Never get off the phone without allowing for questions
Again, this happens in the minority of phone interactions, and I'm not sure why. Imagine the person you loved most was sick in the hospital. Wouldn't you have questions and concerns for the doctor? As the clinician, it's your duty to patiently answer them with empathy and compassion for how worried they are.
A final point to consider is where you are making the phone call from. The majority of physicians will leave the patient's room and then go to a side room and make the call. I do this the minority of the time. My ideal situation is to call from the room, typically using my cellphone on speaker (there are ways to withhold the number or dial through the hospital). Most cell plans are unlimited calling these days, so personal cost should never be an issue! You can make this phone call at the end of the interview and examination, so you are essentially explaining what the plan is to both the patient and family member at the same time.
Remember doctor, you have an opportunity in 3-5 minutes on the phone with a family member to tremendously reassure them that the patient is in good hands and that you are a caring doctor. In communicating with other human beings, it's the little things that count, and going the extra mile and leaving an impression often only takes under a minute.
Finish off with a line like: “We'll be taking good care of mom.” Don't underestimate the power of your words and how the person hanging up the phone can immediately think, “Wow, that seemed like a great doctor!”
