Issues of trust and power relate to communication in complex ways. This is as true in the health sector as anywhere else. And more professionals are paying attention to these issues today, because of widening health disparities and the urgency of vaccine communication. Hear one physician’s stories of how he navigates trust, humility, power and respect in patient communication.
In patient communication, today more than ever, issues of trust and respect, humility and power, are important–and they’re difficult to navigate. In today’s episode, I talk with Dr. Jonas Attilus, who calls in from Boston, and tells us how he deals with these issues as a physician.
This is 10 Minutes to Better Patient Communication from Health Communication Partners, and I’m Dr. Anne Marie Liebel. Today’s episode sponsored by Maven Roth Group, who thanks our Healthcare Heroes for their hard work during this difficult time. Maven Roth can help take some of the work off your already full plate, because they’ve been teaming up with hospitals and practices for years, helping them communicate with their audiences through print, social media, and more. Now let Maven Roth help you create and share your COVID-19 messaging. Visit MavenRoth.com today.
Anne Marie: I’m live via Skype with Dr. Jonas Attilus (@jonasattilus). Dr. Attilus is a first-year resident and internal medicine at Boston Medical Center. Dr Attilus, welcome to the show!
Jonas: Thank you for having me. I’m so excited to be here and to have an opportunity to speak with your listeners.
AM: So you and I know each other from the Social Medicine Consortium and we have been talking lately about patient education and about health literacy ’cause they’re both topics that we care deeply about. And you also have a podcast show!
Jonas: Yeah we do. We have Social Medicine on Air, where we tried to share with mostly with people want medical school, public health, nursing school, all the people inside our medical community, to understand the social aspect of medicine. To understand that medicine is not only about the biomedical aspects. There is, you know, emotion, there is social barriers, there is all the social aspect that we don’t learn in medical school, but that help you to become a much better Physician, and a much better Human Being too.
AM: You and I have talked about quite a number of different topics. And we thought it would be nice to just get on the show together and continue that discussion. So what it, what would, what’s been kind of front of mind for you lately?
Jonas: You know something that is really interesting in medicine is like, we receive an undergrad education. And then medical school education, and then four years of training, and some people receive seven years of training. But we sometimes forget our long journey, and we sometimes forget at some point we didn’t know that much, and that deep, in medicine. So the patient that I have in front of me, it’s like, it’s like me, but like 8 years ago.
Jonas: Like in the past. So, so sometime we forget that the level of knowledge the patient has, I used to have it. But now because I went to medical training, so my knowledge is broad and deeper. And now you have two people in two different perspective, trying to communicate to each other. And that create a sense of sometime frustration, unsatisfaction, or sometime misunderstanding. Because it’s like me speaking a different language and then one person is speaking Creole or Haitian Creole or French and then while the other person is speaking English. So I use this image just to help people understand that sometimes we have to go back, and help them understand. Things that we used to understand at a different moment in our life.
AM: This kind of this image of you as your present self and then looking at the patient as ‘well remember how I was eight years ago?’ You have these these two people and this, this kind of past self. How are you dealing with this rather complex issue of trying to remember when you didn’t know what you know now?
Jonas: I think the first thing, I tried to become aware. Become present. Become aware that at some point, I, I was not able to know that much in medicine. But also the people around me– lets say family, or people who were not going through the medical journey that I did– also remind me that past self, the person I used to be, when I didn’t know that. So now when I’m in front of the patient, I try to remember all that. And say, ok I have this patient in front of me. I have a patient has a kidney failure for example. And it’s like you have a big highway and you got a lot of car. All those car create a traffic jam. That’s what happening with this protein that should stay in your muscle, now is in your blood. So by blocking that, blood cannot pass. So it start damaging your kidney. So not only the myoglobin, which is the protein, can affect directly your kidney, but also the fact that it’s blocking, doesn’t allow the kidney to work proper. So by using an image that people see everyday, I can help them understand what’s happening.
AM: I feel like from what I hear in, in my conversations across the health sector, it seems like it can be a slippery slope, sometimes, from explaining something to a patient in everyday language, to starting to talk down to that patient. As if they were a child, which is pejorative. Or if they were, as if they didn’t know anything, as if they were an empty vessel, which is insulting. How do you avoid this?
Jonas: Ok, I have a blessing. I have a gift. Both of my parents didn’t finish elementary school. Ok? So I’m a first gen. So when I’m speaking with my parents, I cannot talk to them the same way I’m speaking even with my older brother. Because my older brother, he’s an engineer, so he can understand a lot of things that I’m explaining. So when I’m speaking with my parents, I have to use language that they can understand. And they will remind me that, too. My, I would like, I will say something to my dad, and he will say: now say it I can understand it. So because I already know my parents are like that, and I already know that’s how I should speak with other people who don’t share the same background as me, so I’m always trying to not use medical term as often as I can.
AM: So there is a lot in what you just shared that as an educator I agree with wholeheartedly, and as a literacy researcher I agree with wholeheartedly. What are you learning from trying to speak with your patients in this way?
Jonas: Well I learn every day, you know. I never, I never had a chance to speak with a patient without learning from, something from the patient. Like, it’s you know I never, it’s like, everyday somebody teach me something different. Something that I may not think–they always open my mind to something. They always teach me, teach me something!
AM: And the things that we can take for granted about the way that language relates to culture in the healthcare setting, how do we judge people when they’re not using the language that we expect? When they’re not using the terminology that we expect? And how easy it can be to make judgments about them, based on their not meeting that the rules that we have in our head that maybe we haven’t had a chance to look at. What would you say–do you have any words of advice to, to Residents who are listening? To Attendings who are listening? To medical students who are listening?
Jonas: I feel like it’s normal for people to mistrust us. So, so when somebody trusts in me as the doctor, that’s a privilege. That’s a responsibility. And that’s a power, too. It’s like in Spiderman, it say, with great privilege, with great power comes great responsibility. And I think the opposite it also true: with great responsibility comes great power. So, so. So if I have to speak with a medical student , and attending or whoever listen to me right now, I would say: understand you have so much power. You represent power actually. You not only have it, you represent it to the patient. So it’s not the time to show how much you know anymore.it is not the time to try to convince somebody. It is not the time to, I don’t know, to show, to show off. I don’t know. I think it’s the time to step back and say, ‘I know this patient understand how much power I represent. Let me try to communicate in the language that person can understand.’ and I think whenever we do that, the patient can pick that up. The patient can pick up who is behaving in a human way with with him or her, and who’s being rude.
AM: Thank you. Thank you for being on the show, Doctor Attilus. Thank you for sharing your stories with us. I really appreciate your time today!
Jonas: Thank you. Thank you for having me. And thank you for taking your time, not only to interview me but also to share knowledge.
AM: Thank you! This has been 10 Minutes to Better Patient Communication from Health Communication Partners. I’m Dr. Anne Marie Liebel.