One of the most important roles I play as a physician is the management of patient expectations.

The reason it’s so important stems from the nature of my work. As a gastroenterologist to small people I work in a grey-zone. I live in the space between intestinal pathology and the complicated lives of growing children and families. And if you know anything about children, families, or diseases of the gut you can appreciate that this is a tricky area.

Clashing expectations result in physician-patient tension

So knowing what we can expect from both bowels and kids isn’t always clear. And it’s helpful to make that clear.

Because when parents have one idea about how a problem or treatment might evolve and it doesn’t go that way, anxiety will consume them. Then in an effort to understand and correct their child’s issue, they’ll pull you in until they either 1) understand or 2) the issue is resolved. This, of course, is the job of a parent. The resulting push-and-pull with the healthcare professional is a consequence of clashing expectations.

So if the problem isn’t immediately correctable, it at least needs to be understood.

What a patient understands and believes is at the root of patient expectations

Getting your hands around what a patient understands, believes and is concerned with sits at the root of managing patient expectations. Balancing those beliefs with a clear understanding of the facts and the natural course of the problem will reduce the tension that often plagues the relationship between a doctor and patient.

• Tell them what you can do and what you can’t.
• Discuss what’s known and unknown, what’s certain and what’s best guess.
• Let them know how things might progress, whether it’s great news or not.
• Tell them what they need to accept and remain hopeful about.
• Determine whether it represents an acceptable course of action.

Then do your best to exceed expectations.

If you like this post you’ll love the Doctoring 101 Archives. These are all the 33 charts posts that deal with the art of doctoring. This is probably the closest collection of writing that I could offer medical students and residents on how to care for patients. It’s not perfect, for sure. But that’s the nature of dealing with humans. Remember that every post here has tags at the very bottom that will help you find related material. Check it out and happy reading.

Image modified via Flickr and is identified as in the public domain.