Many believe that a long visit with the doctor is a good medical visit. This is the long visit fallacy. Years ago I had a partner who related poorly to parents. So after some discussion and counseling he thought he’d fix the problem by spending more time with families. Time, of course, is correlated with compassion. And caring doctors take lots of time, we ... Continue Reading about The Long Visit Fallacy – The Right Attention for the Patient
When I evaluate a new patient, I work to compress data collection and screen time on the front end of the visit so I can free up the remainder of the visit for face-to-face discussion and shared decision making. This intentional visit design is necessary because of the realities of modern clinic schedules. And so the questions I ask and their sequence is important to ... Continue Reading about Clinical Interview Question: What Do You Think is Going On?
Not long ago I entered an exam room and was met by a mother who immediately began talking. From the chaotic feeding to her sequence of formula roulette and the staccato of the baby’s cry, she delivered a near full history of present illness in the span of 45 seconds. And all with one breath. While I was impressed with her delivery, I couldn’t keep up. So I ... Continue Reading about Interrupting Patients for the Right Reasons
This is my first question for hospitalized patients: Tell me what you understand. Let me explain. I’m a pediatric specialist. I help hospitalists and pediatricians care for children. Actually, I’m typically one of several providers helping families care for a medically complex children in the hospital. And for better or worse communication can sometimes be ... Continue Reading about Tell Me What You Understand: My First Question for Hospitalized Patients
I have a friend who works at a small hospital in the Midwest. In the pursuit of improved patient experience, the administration studied what made patients happy during clinical encounters. One of strategies they discovered was the concept of forward-leaning posture. Evidence supports the idea that leaning in is associated with concern and attentiveness. So the ... Continue Reading about Leaning In to Patient Experience
If you visit my clinic, I follow a structured process during the the encounter. It’s fairly traditional but has some hidden twists that I think are worth thinking about. Here’s how I structure a patient visit: Introduction (provider directed). During the first few minutes I try to connect and find some type of common ground with the child and parents. Basic, ... Continue Reading about How I Structure a Patient Visit