Can We Talk? The Importance Of Open Communication In Health Care

Featured Speaker

Anita Ruff, MPH

Advancements in technology have improved lives in a lot of ways and nowhere is that more evident than in health care.

From leading-edge surgical technology to devices to electronic medical records, technology has improved efficiency and outcomes.

However, one thing that technology can never replace is direct communication between the patient and caregiver.

Let’s talk about talking – and how asking the next question – and getting the right answer – provides an avenue to safer, higher-quality care.

Anita Ruff, MPH, and Melanie Cole, MS talk about the best ways to open communication lines with your health provider.

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Melanie Cole (Host): Advances in technology have improved the lives in a lot of ways, and nowhere is that more evident than in the health care setting. From leading edge surgical technology to devices to electronic medical records, technology has improved efficiency and outcome. However, one thing that technology can never replace is direct communication between the patient and their caregiver. My guest today is Anita Ruff. She’s the director of community education program at MaineHealth. Welcome to the show, Anita. So, what’s going on today in the technology versus that one-on-one communication and how important is it that we maintain that interpersonal communication with our health care workers?

Anita Ruff (Guest): Well, it’s important for us to continue to have those face-to-face interactions with our providers because that’s really where the trusting relationship is developed. With technology, those are great resources and tools to provide efficient care for both the providers and for patients. So, really the one on one is where those relationships are developed so that over time, patients can really trust their providers to work with them on their health care over their life span.

Melanie: What if people feel that their providers are just too busy? Because we see the offices get so crowded and so busy. Do people feel that they can’t just sit down and take a deep breath and tell their health care provider really what’s going on in their lives, or is it really an effort now by the health care provider to make us feel like we’re here to listen to you?

Ruff: I think that we still often feel as patients that our doctors don’t have enough time to sit down and talk with us, which is why as patients, it’s really important that we identify what are the most important things that what we want to talk to in our doctor visit. So, what I tell patients is don’t go in with a list of 20 questions for 20 different complaints. Focus on one thing for your visit, pick three or four questions or concerns that you have the most information that you need to have a conversation with your doctor about, and focus on that. You have other healthcare issues that you want to talk about, schedule another appointment. That gives you some freedom to have those conversations, and it also relieves the pressure from the physician to feel like he or she has to answer all of those questions in a short time.

Melanie: So we should be writing down the questions and bring them in. You feel that that’s important?

Ruff: Absolutely. Before your visit, you should think about what are the most important things you want to talk about. Make a list of those things. Prioritize them. What’s the major piece of information you need to know? And write it down so that when you leave, you explain to a spouse or a partner or another family member so you can communicate back what it is that you learned in your visit.

Melanie: Now, what about advocating for ourselves and using some of this technology to help -- do doctors like being able to be emailed by patients? Do they not want to have that outside-of-the-office communication?

Ruff: I think one of the most exciting things about technology development in healthcare is the ability for patients to connect with their medical record and their practices through electronics. So, a lot of organizations have patient portals that provide patients with 24/7 access to their medical record, their medication list, and allows them to email with their provider. And I think for providers, it’s a great way to respond at times when either they have downtime in the office in between patients and aren’t having to do the phone-tag scramble that often happens. I think that it really does increase efficiency and it gives patients the feeling of control over their ability to communicate with their provider.

Melanie: Do you think the providers are getting better at this communication? Doctors didn’t used to be. Maybe a long time ago they were, and then it kind of went away, and now it’s sort of going back full circle to really taking the time to listen to the patients. And with the advent of the Internet, people find out a lot more about their diseases or their maladies than they used to. Do the doctors like this ability of us to ask questions that maybe we wouldn’t have known to ask before?

Ruff: Well, I think that in the past, the doctor was the person who took the lead in the health care conversation and the patient just followed the doctor’s lead. But today, really, we know that a good patient and doctor relationship is more of a partnership. And so, they’re working together to be a team in addressing the health care concerns of the patient. And the team also includes the nurses, the physician assistants, the pharmacists, and other health care providers. So, you have a lot of opportunity as a patient to get your questions asked and answered by a variety of people beyond just the doctor, as has been in the past. So, I think that most doctors now understand that patients are coming to them more knowledgeable and engaged in their health care. And so, the Internet has definitely played a huge part in that. The ability to access health information has exploded. That doesn’t mean that patients have access to high quality health information now, and so, I think that one of the things that’s really important is to make sure that patients have access to resources that have been vetted and are reliable and have been created by a trustworthy site. I think that providers really want to have a conversation with patients about their health care when they can have the conversation around things that are evidenced-based. I think that it’s probably frustrating to have to dispel a lot of the myths that you’ve seen on the Internet because it takes up valuable health care time when it could be more productive, perhaps, talking about the personal questions and issues that a patient may have.

Melanie: Anita, give us the words to start if someone feels that their health care provider -- and I will ask you about the team again. But if their health care provider isn’t listening to them, give us the words to say to start that line of communication so that people understand how to start that conversation. Because it can be a little uncomfortable. You sit there, it’s very intimidating. So what do we say to begin that communication and say, “You know, I really need you to hear what I’m feeling”?

Ruff: Right. I think that the first thing is to be honest with your physician and be honest about what is going on in your life, be honest about what’s going on in your physical needs, and really be clear that you’re building this honest, trustworthy relationship. When you feel like you haven’t been heard or if you feel like you haven’t been rushed, tell your doctor. It’s okay to say, “I have a lot more questions. I’m really concerned about this and I don’t feel like we’re having the time that I need to really better understand what’s going on.” You could say, “I know that you have many patients to see, but I’m still really worried about this. I’d feel much better if we could talk about it a little more. And if you don’t have the time to do it, is there someone else on your staff who might be able to sit down with me and walk me through what’s going?”

Melanie: That’s a great way to ask. Now, speaking about the other people on the staff. How do we involve that team? You mentioned nutritionists, pharmacists, nurse practitioners. Is it insulting to our main health care practitioner if we asked to see or speak with some of these other people?

Ruff: Absolutely not. I think everybody realizes that there’s a role for a variety of people and a variety of skills in the health care team, and so, having a conversation with the nutritionist is a great way to learn more in-depth information about how to improve your diet, perhaps manage your blood glucose, things like that. That isn’t going to be easy to do in a regular doctor visit. And so, I think that more and more, we’re creating a health care team that’s within practices recognizing that everybody brings something different to the table and that if we all work together, we will help the patient achieve their outcomes in a much better and coordinated way.

Melanie: And Anita, in the last minute, tell listeners why it’s so important that they maintain good communication with their health care providers and why they should come to Maine Medical Center for their health care needs.

Ruff: So, the biggest reason why you need to have a good relationship is because this is the person that you need to be able to trust when you’re having health issues. You need to have that ability to be honest with somebody about what’s going on. You need to feel heard, and you need to feel like you’re working together to address your issues. It also is important to become a patient at Maine Medical Center, because we have a lot of physicians and staff who are really interested and engaged in keeping patients healthy, taking the time to hear what they have to say, and really working together to figure out the best way to keep people healthy and to live the kind of life that’s healthy and productive that everybody wants to have.

Melanie: Thank you so much, Anita Ruff. You’re listening to MMC Radio. For more information, you can go to mainemedicalcenter.org. That’s mainemedicalcenter.org, mmc.org. This is Melanie Cole. Thanks so much for listening.