Page 43 - Delaware Medical Journal - May/June 2020

PRACTICE MANAGEMENT
Why (and How) to Make Time for Difficult Conversations with Patients
Tina Irgang Leaderman Primary care providers are frequently
pressed for time, and it can be hard to connect with patients on complex or sensitive issues they may be struggling with — say, sexual and gender identity, domestic violence, or homelessness. We asked some experts to weigh in with advice on how to approach (and make time for) these conversations.
“When I look back to medical school and residency, I don’t feel like I was really taught to have good listening skills or to really put myself in the shoes of the individuals that I’m
trying to help,” says Karyl Thomas Rattay, MD, MS, the Director of the Delaware Division of Public Health. “I think asking open-ended questions has almost been a fear in many ways for physicians, because the reality is our time is limited. Opening a can of worms with a patient can set you back from a time perspective, and that can lead us to not delve into some of the issues that we should be talking with our patients about.”
So what are some of these issues? And how can you approach them in the right way? Here is the experts’ advice.
DON’T SHY AWAY FROM THESE TOPICS
Social determinants of health can
have a tremendous impact on a patient’s health outcomes, medication adherence, or ability to manage a chronic condition. In fact, “social determinants impact a greater percentage of somebody’s health than their genetics do,” says John J. Fink, MD, a family practitioner at Bayhealth.
That’s why it’s crucial to focus on these aspects of a patient’s life, says Rattay.
Del Med J | May/June 2020 | Vol. 92 |
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