GLMS EVENTS
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Language and how we ask questions affects how the conversation flows , and open-ended questions can be beneficial . For example , instead of asking at the end of an appointment , “ Do you have any questions ?” Dr . Porter suggests rephrasing to , “ What questions do you have ?” In addition , body language such as looking directly at the patient while still seated can elicit a more open and honest conversation . Dr . Fernander added that it ’ s essential there is a space for that conversation to happen so that you get the most accurate patient information .
“ It ’ s important to remember that while physicians are the experts , patients are the experts on their experience , what they ’ re experiencing and what they ’ re feeling . We need to allow the patient to express what they need to express ,” said Dr . Fernander .
The conversation then shifted to how physicians can better understand someone who may come from a different background . Both Dr . Porter and Dr . Fernander agreed that we must find a commonality or similarity with patients to help build a connection . Humanizing factors can also help bridge the divide . Using humor or even telling a patient that you don ’ t know the answer can help to show that you are still human and make you more relatable .
Motivational interviewing for a more vulnerable population can be challenging , but it all comes back to making a connection and understanding where they ’ re coming from . Dr . Porter suggests putting the ball in the patient ’ s court and allowing them to have input .
“[ I ask ] ‘ What ’ s the change that you would like to make ?’ I try to give them some choices , not telling them , ‘ We ’ re going to do this .’ I try to ask for incremental change , one thing at a time ,” Dr . Porter said . “ Give people small goals so that they can feel like they ’ re accomplishing something .”
There are studies that show that physicians assume a lower health literacy level for Black and Brown populations . Dr . Fernander said that this is likely because of a lack of diverse experiences .
“ We should never make assumptions . We make assumptions because we lack experience and interactions with people who are unlike ourselves ,” Dr . Fernander said . “ We need to make sure that we prioritize interacting with people who are unlike ourselves personally and professionally so that we can realize folks are not that different .”
Dr . Porter pointed out that we must make sure to approach everyone in a way that is understandable to them .
“ Even if someone is ‘ educated ’ doesn ’ t mean they understand your language . When I go to the accountant , I don ’ t know what he ’ s talking about , that ’ s not what I do every day . [ Medicine ] is not what they do every day , so you should try to teach your patients . That ’ s what doctors and providers are supposed to do .”
With COVID-19 vaccine conversations at nearly every appointment , both speakers said that it is important to gauge where the patient is coming from and the climate of the conversation . Appeal to the patient ’ s concerns and explain any misinformation in a non-judgmental way and provide them with correct information .
In closing , Dr . Fernander discussed how the stress of a day ’ s work can impact patient care . When stressed , physicians are more likely to act on unconscious and implicit biases . Taking the time to stop and take a breath before going into the exam room can make a positive impact on both the physician and the patient and the overall experience .
Dr . Porter echoed the need for self-care and added that a practitioner must always be prepared for curveballs and different patient experiences .
“ People come from different places , and you might not be familiar with how they do things , but don ’ t be so judgmental that you make judgements based on that ,” Dr . Porter said . “ Learn where people are coming from . Once you know the reason behind why they ’ re doing what they ’ re doing , you can try to help them find strategies to fix things .”
To view full videos of each of the three sessions , visit glms . org / racial-inequality .
Kathryn Vance is the Communication Specialist at the Greater Louisville Medical Society .
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