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Toni Talks about PT Today

Better Patient Communication

Published May 31, 2011 1:25 PM by Toni Patt

I overheard a conversation while walking to the garage this afternoon that made me shake my head in disbelief. Someone immediately behind me was attempting to explain the results of an MRI scan to someone else over the phone. The only parts the caller got correct were that it was an MRI scan and it was performed on someone's brain.

We all have stories of some patient completely misunderstanding directions for an exercise program. You spend an hour meticulously teaching a HEP only to have the patient come back the following week and do it completely wrong. Or we've had patients who do exactly the one thing we tell them not to do because that was the only thing they remembered. It's human nature.

What I heard earlier today was particularly funny because I've actually heard a doctor describe the same results to someone else. I'm sure my caller listened very carefully to the explanation. He was able to explain what the results of the scan were. He just didn't have a clue what the rest of it meant. Just before I turned the corner I heard him say if they did another scan the person could go to rehab. I can't even begin to figure out what that meant.

I need to remember this. No matter how carefully I explain something, it probably isn't sticking. I read while I was studying for something that a person must hear something six times before it begins to form into a memory. I'm pretty sure that also means in the same context each time. Word choice is also important. We attach emotional meanings to words like stroke, hemorrhage and damage. Whereas words like fractured or broken create different images.

I once said "stroke-like" in trying to explain something to a daughter. From that moment on, you couldn't convince her that her mother had a stroke. It was something stroke-like. Stroke-like didn't sound bad. Stroke apparently did. The actual diagnosis was more severe than a stroke but she never snapped to that either. It was her coping mechanism.

This is one reason doctors carefully document exactly what they say to patients. It's easy to see how someone could later claim "no one told me that" when it was actually a case of ineffective hearing. It's better to give information in small blocks that are frequently repeated. That's how the brain relearns motor function. It makes sense that it would learn other things the same way.

2 comments

A patient's view.

With troday's computers, surely it is easy to ensure that patients take away a sheet of clear instructions, with important phrases highlighted.

I think it is particularly important to have positive lifestyle changes incorporated, specific to the patient, so that, after each visit, gradual improvements to lifestyle are encouraged.

After all most health problems are caused by inappropriate lifestyle choices, too little exercise, too much of the wrong food etc.

Mike Maybury July 31, 2011 3:43 PM

Toni,

As you have illustrated so well, this is a concept that cannot be revisited too often.  Thanks for reminding us about how easily miscommunications can occur, especially in the emotionally charge environment most of our patients find themselves.

Janey Goude June 2, 2011 2:00 AM

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