Providing Care Beyond the Mask

I like to think that I do a good job with my patients.  I really try to ensure I've addressed all of their concerns, and that they have understood what I am explaining.  A few weeks ago, I apparently got it wrong.  What I had thought was an uneventful visit, surgery and follow up was exactly the opposite.  The patient came back months later to express her disappointment in me.  To be clear, I provided excellent care, and she did well from her surgery.  I just didn't fully appreciate her concerns.

I feel terrible when this happens.  However, I am so grateful that she eventually came in to tell me.  You see, she was one of my cases in the beginning of the shutdown.  Much of her discussion was virtual and/or behind a mask.  From my recollection, everything seemed straightforward and just fine.  In fact, she told me she was doing well at her virtual post op appointment.  It was obvious that this phone visit was not adequate.  Luckily, we only had to do those types of visits for a couple of weeks.

In "normal" times, I can see my patient's facial expression and often pick up on subtle things that clue me in that they are not understanding, they may have more questions or they don't like my answers.  As a surgeon, I quickly realized that virtual visits were not adequate for what I do.  We discuss surgical procedures, cancer and serious issues.  We often need to "see it. feel it and touch it."  Although all of my appointments are in person today, the mask makes everything that much harder.  I can't read their expressions, they are often alone, and I am vulnerable to thinking everything is just fine.

My patient's complaint has made me address this issue even more than in the past.  I am asking my questions repeatedly, and checking more than once that they have all of their concerns addressed.   I am giving more written handouts and providing them more than once.  I am so grateful to my patient for giving me feedback.

The masks and protocols are going to be around for a bit.  As a patient, make sure to have your questions prepared and written down.  I love when the questions are given to me ahead of time, so I make sure to answer everything.  Don't be afraid to speak up if there is something you don't understand.  

My patient reinforced that as physicians, we need to hear the hard stuff too.  These are opportunities to learn how to improve and relate to what our patient's are going through.