Building Long-Term Communication Success is the final subject in a four-part article series that provides more information about ASA’s Enhancing Patient Communications Program.
ASA has received positive feedback on the guidance in our Enhancing Patient Communications Program toolkit, specifically its importance. The program, which was developed in part to provide anesthesiologists with resources to help enhance their own communications with patients, will realize its full potential only if the suggestions are purposefully implemented.
Dr. Hatch: I encourage everyone to accept a small bit of humility, recognize that we don’t have it all figured out, and ask ourselves honestly if there is anything we can do to improve our patient interactions. I recall one interaction early in my career when I felt confident I had done a good job communicating with a patient and their family, yet afterward, the family said, “the anesthesiologist seemed rushed and not concerned with our questions.” I’m sure I covered all of the legal formalities and explained the anesthesia we would be administering. But that is not what the patient or family heard, and their experience was very different from mine. That experience started me on a lifelong journey to look for ways to better communicate with patients and their families.
The Enhancing Patient Communications Program is helpful for anesthesiologists at any level in their careers, and we’re hoping the toolkit will be a catalyst for department heads to emphasize patient communications among their staff. It’s especially important for medical students, residents, and early-career physicians since, unfortunately, patient communication is not robustly taught. Ideally, every residency training program will implement some aspect of the toolkit into their curriculum, and ASA resident component leaders and state component societies will spread the word to help ensure lasting change.
Dr. Striker: At our institution, we showed the toolkit to the training program director, and they have already introduced it into the curriculum for the upcoming residency class.
As a profession, we need to examine curricula that have incorporated patient communication skills to see what’s working so that we can develop a program anesthesiologists can implement at their institutions. In the meantime, the final section of the toolkit, Building Long-Term Communications Success, provides some key principles to employ with the goal of cementing patient communication practices in the long-term.
Engage in deliberate practice
We all know practice is the key to becoming proficient at anything, and it’s no different with patient communications. While the suggestions included in the toolkit are simple concepts, a sustained effort is required to integrate them into your practice. Mastering the fundamentals in any field also is key to becoming an expert, and patient communications certainly fall into that category.
Don’t feel as though you need to incorporate all the suggestions at once. Consider focusing on improving one aspect of your communications every day. For example, how you introduce yourself to your patients and explain your role. Think about what you want to say and then practice it out loud, perhaps in front of a mirror or with a family member, friend, or colleague.
Observe your patient’s reactions and modify your approach based on their response to you. Think about your patient encounters after the fact and consider what you might have done differently.
Learn from each other
Observing other anesthesiologists can be helpful, both in terms of garnering new ideas for communicating and for seeing what doesn’t work well. Although we rarely observe colleagues at work, it’s a low-effort way to learn new techniques, and we should all consider doing that more often.
Dr. Striker: The times I’ve observed colleagues, I’ve always learned something from them. Additionally, it’s beneficial to have a colleague observe you and give you feedback.
Early in my training, I loved working with an anesthesiologist who developed rapport by joking around with older patients, and they always laughed. One time, he made a joke that I thought would make the patient more anxious right before induction. It had the opposite effect. The lesson I took away was that everyone is different, and the best communicators know just how to develop that rapport with each patient. Some patients relax when you joke with them, others would not appreciate it. But just watching how he interacted with patients made me realize there are many ways to go about making patients comfortable.
Over the years, I’ve learned from others, in addition to that doctor. I’ve seen that some anesthesiologists are highly skilled at relating to children, playing games with them, using imagery, making things fun for them instead of scary, and I’ve certainly incorporated some of those tactics in my approach.
As your trainees observe you, let them know you aren’t perfect, but that they’ll get an idea of how you break the ice with patients. In the process of having them watch you, perhaps you’ll realize you can change some things, too. When you observe residents, you might learn from them as well, either in their approach or by noting something they could improve, and then making that change in your approach.
Dr. Hatch: One simple thing we can all do as anesthesiologists is to ask our perioperative nurses how they think we come across to patients. I remember pulling a nurse aside and asking her honestly how she felt I presented information to the patient. At first, she was afraid to be fully honest with me, but later she said I may have spoken too quickly for my southern patients, and they may not have fully understood everything I was saying. That was immensely helpful to me, and since I was born near Chicago, I now incorporate a Midwest joke about how my brain is wired differently and I talk fast. I always ask every patient and their family if there is something they want me to go over or repeat.
ASA is developing CME models to help you implement and practice the toolkit suggestions in your interaction with patients. Stay tuned for more information on the offerings.
A key section of the toolkit involves focusing on how you introduce yourself and your roles, including team members and your position as the leader of the anesthesia care team. If you want more insight into how to present yourself as an anesthesiologist to patients and the public, consider signing up for ASA’s Leadership Spokesperson Training Program, which is offered during every annual meeting and during the annual LEGISLATIVE CONFERENCE.
Dr. Striker: During the training, you’ll be videotaped as you practice speaking about the specialty. When you watch the tape – which is used only for your personal learning – you’ll get a lot of insights into your delivery style and may realize you have work to do to improve how you communicate about anesthesiology. I’ve participated in the program, and it’s truly a valuable experience. You may think you know how to talk about the specialty, but during the training, you’ll realize there’s much you can improve.
As an anesthesiologist, you are committed to evolving your medical knowledge over time, and patient communications should be part of that evolution. As you read through the toolkit, we believe you’ll find there are some suggestions you may want to incorporate in your own interactions and some aspects of your communication that you could improve upon. By reviewing the suggestions and committing to a little practice, you’ll improve your skills in ways you never imagined.