In today’s episode, I talk about time with otolaryngologist and podcast host, Dr. Bradley Block. He shares some of what he’s learned about efficiency in patient communication.
Time. It’s the ultimate constraint on any interaction. In today’s episode, I talk with otolaryngologist and podcast host, Dr. Bradley Block. He shares some of what he’s learned about efficiency in patient communication.
Hi, everybody. This is 10 Minutes to Better Patient Communication from Health Communication Partners. I’m Dr. Anne Marie Liebel. Our course Equitable Patient Education promotes high -quality clinical practice in patient education by helping prevent avoidable errors. Learners say “there’s a lot of eye -opening information I hadn’t considered before,” and, “this course helped me look at myself as an educator and helped me to step back and analyze how I can be a better nurse.” For more information, visit healthcommunicationpartners .com.
So today, I get to share with you my interview with Dr. Bradley Block. Dr. Block is a private practice Otolaryngologist on Long Island, New York. He’s a partner at ENT and Allergy Associates and creator of the Physicians Guide to Doctoring Podcast. I’ll put links in the show notes. And Dr. Block said he started this podcast series six years ago to improve at doctor -patient communication and he’s expanded the topics to include, as he puts it, “everything we should have been learning while we were memorizing Krebs cycle.” It was very fun to sit down with him and he’s going to have a lot to share with you about what he has learned about efficiency in patient communication. Here’s Dr. Block.
Dr. Bradley Block, what is an issue or a problem in patient/physician communication or patient education that you have been facing?
My main goal, I guess, has been to tackle efficiency. Not just communicating well, but communicating well efficiently. Because it’s important to me that I’m respectful of the patient who’s in front of me. I want to make sure we cover everything that they want to cover in a reasonable timeframe . But also I want to be respectful of the people in their waiting room and their time, and the people waiting at home trying to make appointments. Because if we let people fill as much space as they want, there’s not going to be time for the people in the waiting room and the people at home to make appointments. So efficiency, without sacrificing doing it well.
That’s a big issue and ever since I first started talking to folks in the health sector, one of the first things that people are going to say is, “But I only have 10 minutes. You know, I only have 15 minutes,” (this is why have a 10 minute podcast series) “I only have such a short amount of time.” You know, and that in itself can be just alarming. Just an unbelievable amount of work that you’re supposed to do in an unbelievably short amount of time, complicated issues, enormous institutional pressures anyhow. So it makes sense. I can get why efficiency is something that’s got to be top of mind for a lot of people. So how have you been facing, I mean, probably there’s many things that you’ve been doing to face this issue of efficiency. But what would you like to talk about?
Thinking back, how have you faced the problem of trying to be more efficient in your communication?
First, I started consuming podcasts to try and learn how to be a more effective and efficient communicator. And then I ended up creating this podcast where it’s not everything we cover, but it’s a lot of what we cover. And it’s, the main impetus for me to create it to begin with. So that’s how I faced it. It sounds ridiculous, now that I’m saying it out loud. But how did you face this communication challenge that you had? “Well, I created a podcast and i’ve devoted the last five years or so to it,” but yeah, that’s how I did it.
And there’s something enormously courageous about that. We talked about Raj Sundar earlier and he also had a similar impetus. He’s like, “This is a thing I don’t know. It is so important to me. I am going to educate myself, and I’m going to do it in a specific way. I’m going to consult experts, but I’m going to ask them to talk with me. I’m going to ask them to tell me their stories.” And that sounds like something that you have done. But it’s enormously brave because you’re putting yourself out there. You’re not just having these conversations in the privacy of your own home. You’re going public with this.
Yes, which has never been an issue for me until my patients find it. And then I’m like, “Oh, what did you hear me say?” And it doesn’t happen that often. You know, I never know which one they happen to listen to. You know, I never know what I end up saying because, you know, sometimes what I talk about is my own fallibility. And the challenges that I’m having. So if my patients listen, “Oh, he’s having these challenges,” but nobody’s ever taken it that way. Everyone’s always been like, “Oh, wow, he’s trying to improve himself.” So, you know, they take it as it is, as it’s meant to be, which has been nice.
What do you think you’ve learned? I mean, you’ve been doing this for five years, almost six years now. I’m sure there’s quite a lot of learnings that you’ve had about communication. I’m sure you’ve learned a lot about your patients. You might, it sounds like you’ve learned some things about yourself. You wanna talk about any of those?
The surprising thing that I learned is– ’cause I think if I go back to like a specific episode, yes, I mean, you know, each one– nonverbal communication, and the one we talked about before the show is that we developed these heuristics, these spiels that we, you know, so we can kind of like shut off our brain and just talk. And rather than doing that, you know, actually using that extra bandwidth to read the room and improve each visit. You know, it could go into each one and boil it down. But I think one of the surprising things that i’ve learned from doing the show and then incorporating what i’ve learned into the exam room, is that it can actually make the visit more cognitively taxing for me, not less so. Because if I didn’t care, and I just went about the visit and I listened and I examined the patient, and I told them what it was going to be and like the old school paternalistic way, “this is how it’s going to be,” I’m not taking any emotional baggage away from them. But because it’s so important to me that each visit goes well and I’m trying to incorporate all of these different things that i’ve learned into each visit–It’s a lot! It’s a lot. And even though it’s made me more efficient and it’s made me better, it’s also, you know, the goalpost never stops moving. And it’s my goalpost that i’ve set for myself! It never stops moving. So i’ve moved it further away. And therefore, like I have to be better. And so now I’m trying to incorporate this stuff. So then I have to be even better. And it just, the goalpost, it’s always out of reach. But you know, that’s– most visits end up going really well and are not that challenging. But then those challenging ones really, they end up being more emotionally taxing.
Thanks for that. And thanks for that honesty. And again, a lot of courage and a lot of bravery there. Because I can only imagine how much pressure there is on you to at least seem like you’ve got it all figured out, to sound like you’ve got it all figured out. I know that in my years, now in the health sector, i’ve witnessed this kind of feeling that there is ‘a right way’ to do things. I understand medicine has to be standardized in a lot of ways, but we also understand people aren’t standardized. There seems to be like an inherent tension in there that I think people maybe are getting more comfortable talking about a little bit. But I hear you saying, “Oh no, I’m absolutely in that tension.” Like, “I’m absolutely willing to say I’m not perfect at this job, and the perfection itself is kind of a pressure that I could do without. Thank you very much. But I’m willing to constantly make myself a little bit uncomfortable by moving those goalposts.” Because you realize that there’s something else you need to learn. And if that’s not something to celebrate, I don’t know what is. This is what reflective practice does. It draws us deeper into our work. Because there’s so much in medicine and healthcare and public health that takes people away from their work. I mean, I’m applauding you on just deciding that you’re going to go down this path of your own learning, even if you have to forge the path yourself. Every step of the way. And when you find out that, oh, it doesn’t just automatically make things easier, it does make them richer. It does have, at least for me, like there’s enormous satisfaction, as much as there is an emotional toll to be paid too. When you are deeply engaged in the work, it takes it out of you. Which is why also I think the show that you’re having is a great idea because you have surrounded yourself with a community, and a community of people who give a damn about some of the same important things. And so when I’m working with clients, that’s something that I’m advocating: do not do this work alone. So I teach people how to, if they want me to, teach them how to begin communities of practice. Because this work is hard. It’s hard doing what you do. It’s hard being reflexive. It’s hard advancing equity. But we’re not in it alone, and we shouldn’t be in it alone. And I think we all know it’s a marathon. So building that community around it is absolutely an essential part of the work. And you knew that, and you did that. What are your next steps? What’s next for you? Or if you would like, give a word of advice to folks who are feeling the efficiency pressures
There are resources out there you can find. So if you’re having issues with efficiency, one, know that you can improve. Because what I hear from some people is, “this is how I am.” But you can be better than you are. And if you don’t try to improve, you’re never going to improve, but you can. Because I hear from physicians all the time, “this is how I am. It’s not going to change. There’s no point in trying. “ And that’s just the completely wrong way to think about it. You can improve. You just need to try. You need to be methodical about it. And you really need to, as you say, reflect. What are the things that are really weighing down my efficiency? and it might be something simple, like get your cell phone out of the room. Don’t open up your email on your screen. Like what are the distractions? Stop talking about yourself so much to the patients. Right? There are things that we do that we really should be able to reflect on. Like what is occupying so much time in my visit? and ask someone for advice. Because if you have like a medical assistant or a PA or a nurse or a partner or someone who sees you seeing patients, they might be able to tell you, as long as you’re ready to hear it. Because you need to reflect and you need to figure it out, because it’s there and you can improve upon it.
Absolutely. Reach out to your colleagues. Even just one colleague. I love that, Brad. And then they can turn around and ask the same of you. you know, can you just observe me for a little bit and what do you see here? How do you see me spending my time? It’s not an error hunt. It’s not a free -for -all. It’s a “Here’s what I see. Here’s what I think jumps to mind when I look across the day of all the cases that I saw you deal with. Here’s something that leaped out to me. Take it for what it’s worth. “ Done in a friendly spirit, done with support, done with the idea that we’re trying to grow as professionals. It’s absolutely doable, but it does take some bravery.
You’ve got to be willing to listen to what might be perceived as criticism. If you’re genuine about your pursuit of improvement, it’s necessary.
Thanks again to Dr. Bradley Block, Otolaryngologist and creator of the Physicians Guide to Doctoring Podcast. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music by Joe Liebel. Additional music by Alexis Rounds.