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‘Docsplaining’ and the Importance of
Good Communication

April 15, 2021

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When Dr. John Launer, a physician and educator in London, wrote about “docsplaining” in the BMJ’s Postgraduate Medical Journal in February 2019, he caused quite a stir in the medical community. Drawing a parallel between docsplaining and “mansplaining,” Launer wrote that the former is, in essence, “unwanted, unnecessary or patronising explanations by doctors to non-doctors, whether these are patients or simply members of the general public who suffer from the lamentable lack of a medical degree.”1

 

Adding that docsplaining is most often targeted at patients and thus more harmful than when it is aimed at the general population, Launer posited that this form of communication “appears to be the rule” rather than the exception among all medical specialties.

 

The response was dramatic. Two months after Launer’s editorial was published, U.S. pediatrician Bryan Vartabedian, M.D., wrote that characterizing physicians in such a way was “an insulting generalization” perpetuating a “perverse stereotype.”2

 

And in March 2020, referencing Vartabedian’s editorial, Physician’s Weekly stated that Launer’s piece was “an unfair generalization of physicians” and one that portrayed doctors as “condescending and uncaring actors in their communication with patients.”3

 

The topic touched a nerve, to be sure. However, controversy aside, perhaps Launer’s editorial can be viewed as a call to arms, if you will, a reminder that effective patient communication is integral to effective patient care. The question is, are your patients being spoken to and heard in the way they need to be? And could your communication skills, as well as those of the people in your practice, use a brush-up? Let’s take a look.

The Trouble With Ineffective Patient Communication

According to a 2010 study published in The Ochsner Journal, ineffective physician-patient communication can cause a number of problems, including a feeling of disempowerment among patients; poor patient satisfaction; and an inadequate understanding among patients of their conditions and treatment steps, which can lead to therapeutic failure. In fact, the study authors point out that the majority of complaints about physicians have more to do with communication issues than clinical competency.4

 

Furthering the problem is that many physicians don’t realize their communication is lacking. The Ochsner study authors cite research that involved a survey of orthopedic surgeons; of those surveyed, 75 percent believed they communicated satisfactorily with their patients. However, among the patients surveyed, just 21 percent stated that they had satisfactory communication with their doctors.

Effective patient communication

How Effective Communication Benefits You and Your Patients

According to the Ochsner study, there are many benefits to effective patient communication, including that it can help you detect medical problems earlier, prevent medical crises and head off expensive medical interventions. You may alAso see better patient compliance, outcomes and patient satisfaction scores, not to mention lower costs of care. In addition, many patients equate a physician’s communication skills with medical competence, the study authors add.

 

And remember: Better patient satisfaction ultimately benefits you and your practice. Effective physician-patient communication is so vital, in fact, that a 2019 article in Physicians Practice stated: “No other area of medical knowledge or technical skill has a greater impact on our patients.”5

Tips to Improve Your Communication With Patients

Remember, proper diagnosis and treatment of your patients is only one part of the equation; your patients also want you to communicate with them effectively and empathically. According to a 2014 Committee Opinion from the American College of Obstetricians and Gynecologists, this involves a three-pronged approach: conducting patient-centered interviews, communicating in a caring manner and participating in shared decision-making with patients.6

 

Following are eight tips to help ensure you’re meeting your patients’ expectations when it comes to communication:

 

  1. Remember that first impressions matter.
    Introduce yourself if you’re meeting a patient for the first time, and greet her by name. Shake hands (or, in the era of COVID, do an elbow bump), smile, and make frequent eye contact.

  2. Pay attention to non-verbal communication.
    According to Physicians Practice, the most important nonverbal forms of communication for helping patients feel connected to their doctors are eye contact and touch.5 On the flip side, try your utmost not to look at your watch or stand with your hand on the door handle.7

  3. Get on your patient’s level.
    Rather than standing above your patient, pull up a chair and sit down. Place yourself so you are face-to-face with her.

  4. Watch your eyes.
    Look at your patient as much as you can. Sure, a quick glance at her chart or your computer screen is fine here and there, but do your best to focus on the person in front of you.

  5. Check your listen/talk ratio.
    It goes without saying, but patients need to feel heard, and this means giving them plenty of opportunity to talk. To make sure you’re giving your patients enough air time, check your ratio of listening to talking. According to Family Practice Management, while many physicians believe they’re listening more than they’re talking, that estimate isn’t quite accurate: One study showed that although patients talked about 54 percent of the time while giving their history, doctors tended to dominate the conversation during the rest of the patient visit.7

  6. Beware of burying your patient in stats.
    Kate Land, M.D., a pediatrician with the Permanente Medical Group in Northern California, has written about her efforts to convince patients of the importance of the flu vaccine. “We feel strongly about the life-saving value of the flu vaccine and want to convince our patients to get it,” she wrote. “When they resist, it is easy to fall into ‘docsplaining’ — citing statistics, studies, and facts. This doesn’t work; it creates more resistance.” Instead, Land recommends talking about the benefits of a certain treatment rather than inundating your patient with the hard, cold facts; not arguing; and using positive terms rather than negative (“safe” and “healthy,” for example, rather than “side effects” and “danger”).8

  7. Actively listen without interrupting.
    While you might be tempted to ask your patient multiple questions off the bat, you may elicit better information, in less time, by letting the patient lead the discussion. According to Family Practice Management, allowing a patient to speak, uninterrupted, for three to four minutes can give you virtually all the information you need.7

  8. Don’t let technology usurp personal communication.
    Sure, patient portals can be a godsend, but don’t make the mistake of letting email or chats take the place of real conversation, the American Medical Association advises.9

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In today’s era of lightning-quick patient visits, taking the time to listen attentively and communicate effectively with your patients may almost seem like a luxury. Yet doing so is not only the right thing to do for patient care, it can actually make patient interactions more streamlined, more efficient and more efficacious. And, in the end, it may make your patients happier and more satisfied … and you as well.

Footnotes:

1 Launer, John. “#Docsplaining.” Postgraduate Medical Journal, vol. 95, no. 1120, Feb. 2019, pp. 117–18. pmj.bmj.com, doi:10.1136/postgradmedj-2019-136440.
2 “Docsplaining - An Unfair Generalization of Physicians.” 33 Charts, 2 Apr. 2019, https://33charts.com/docsplaining/.
3 Mar. 2020. “Docsplaining – An Unfair Generalization of Physicians.” Physician’s Weekly. https://www.physiciansweekly.com/docsplaining-an-unfair-generalization-of-physicians/. Accessed Jan. 2021.
4 Ha, Jennifer Fong, and Nancy Longnecker. “Doctor-Patient Communication: A Review.” The Ochsner Journal, vol. 10, no. 1, 2010, pp. 38–43.
5 “9 Ways to Improve Your Patient Communications.” Physicians Practice. https://www.physicianspractice.com/view/9-ways-improve-your-patient-communications. Accessed Jan. 2021.
6 “Effective Patient-Physician Communication.” https://www.acog.org/en/Clinical/Clinical Guidance/Committee Opinion/Articles/2014/02/Effective Patient Physician Communication. Accessed Jan. 2021.
7 Belzer, Ellen. “Improving Patient Communication in No Time.” Family Practice Management, vol. 6, no. 5, May 1999, p. 23.
8 “Four Steps to Talking About the Flu Vaccine.” Permanente Medicine, 4 Oct. 2018, https://permanente.org/four-steps-talking-flu-vaccine/.
9 “6 Simple Ways to Master Patient Communication.” American Medical Association, https://www.ama-assn.org/residents-students/medical-school-life/6-simple-ways-master-patient-communication. Accessed Jan. 2021.

 

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