To the garden state and back

One of the most surprising elements in the book, “How Doctors Think” by Jerome Groopman, M.D. is right at the start when Groopman says most doctors interrupt their patients within the first 18 seconds. 

A few days ago I went to New Jersey to present diabetes materials at a minor league baseball stadium that was also featuring a small health fair. Funny to see our little table against a backdrop of every unhealthy fast food available, but let’s not go there.

While I talked with a number of people I remember one particular woman who stopped by the table. She was hesitant at first, tentatively looking over what was on the table. Her hesitation and Pacific Islander look immediately made me think she probably wasn’t that educated about diabetes. Yet when I began to ask her about her blood sugar and A1c, wow, she knew her stuff. She told me about her 6.4% A1c and how she want’s to get it a little lower, she told me what she eats and where she can do better and she told me about her last conversation with her doctor, turning her shy smile downward. Hearing her A1c, without thinking I stuck out my arm and shook her hand saying, “Congratulations! You’re doing a wonderful job!” She grinned, she glowed, her smile lifted and spread from ear to ear going right up into her eyes. “Keep up the good work!” I said as she walked away waving and smiling, smiling and waving and thanking me. 

Right before my eyes I saw the affect of congratulating a patient on her hard work. Something I fear not nearly enough doctors do. And I know damn well she’s going to work even harder to get that A1c where she wants it because someone acknowledged her and her efforts. More and more I am convinced patients will do better if we acknowledge and praise, congratulate, encourage and inspire them.

In a Wall Street Journal article, “The Importance of Trying to Be a Good Patient” by Laura Landro, Landro cites medical educator and physician groups that are training doctors to conduct more sensitive interviews, recommending doctors find ways to praise patients for their competencies and express sympathy with how frustrated patients may feel. John Prescott, chief academic officer at the Association of American Medical Colleges, reports more and more communication training programs are trying to get doctors to step back and say, “What’s going wrong with this discussion and how can I change that?” And, the authors of “Breaking the Cycle”recommend doctors let patients speak uninterrupted for three minutes and ask open-ended questions. We hark back to where I began.

As my sojourn out to New Jersey came to an end, the driver of my ride turned to me as we approached my neighborhood saying, “I heard you talking about diabetes…” (I had been on the phone in the car). I explained to him what I do and he began to tell me about his father who died of diabetes and his brother who is having a terrible time with it. And how he and his wife are concerned because they’re both overweight. 

I listened, answered his questions, encouraged him and spent an extra five minutes in the car in front of my building to give him information and a soft place to speak. When I reached for the car door handle to let myself out he reached for my hand, shook it and thanked me, wishing me the best day anyone ever has. I feel now as though it was kismet that I met the two people whom I know I impacted. I imagine they feel the same about meeting me.

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