Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

A low-tech way to improve the physician-patient relationship

Jessica Tekla Les, MD
Physician
June 7, 2018
247 Shares
Share
Tweet
Share

Seventy percent of the children and adolescents I see in clinic are obese so I have many opportunities throughout my clinic day to talk about exercise and nutrition. Although the general message is the same, precisely how I deliver the information matters more than I could have imagined. I found this out quite accidentally.

It was toward the end of the day, two months after the firestorm in Santa Rosa, California. My clinic was destroyed and I was working out of another clinic site meant for teens, but expanded to serve all ages and conditions. Overnight, the clinic went from having one clinician to three and we were working out of every nook and cranny that little clinic had to offer and seeing every patient, whenever they showed up. All us staff were living in that post-disaster survival state, doing our very best to care for our community while not taking great care of ourselves. That day was no different.

Already running 20 minutes behind, I scanned the next patient’s chart and saw this 8 year old weighed 113 pounds, bringing his BMI above the 99th percentile. I took a slug of water, then trotted off to the exam room. After addressing Mom’s concerns first and getting to know the child a bit, I started my obesity and disease prevention pitch. I hit all the highlights — exercise, avoiding sugary drinks and junk food, increasing veggies, protein and fiber — the usual. But instead of saying “I” recommend 30 minutes of break-a-sweat exercise a day, I said “we” as in all of us in the room — me, Mom and the child needed to get 30 minutes of break-a-sweat exercise a day to maintain our health and prevent disease down the line. I babbled on to say, “this is what I am trying to do for myself each day, and right now to be honest, I’m not being that successful.” My words hung there in the air, and I waited, only now fully aware of what had tumbled out.

In the long pause, I noticed Mom had been fiddling with her purse strap and it wasn’t until she let it go and her shoulders relaxed, I realized just how tense she was about this conversation. Instead of the regular parental nod or the “did you hear that?” directed at the child, the Mom looked me directly in the eye and asked, “exercise is hard for you too?”

And just like that, the door of opportunity for motivational interviewing swung open with a family I had never met before.

We went on to have an honest conversation about why it is hard to make changes, what would make change easier, naturally leading the Mom and the child to voluntarily making their own realistic goal for better health. There is no doubt that this family faces far more barriers to exercise and healthy nutrition than I, but in our common ground of “yeah, sometimes it’s hard to do things even when we know it’s really important for our health,” we had a meaningful conversation that maybe, could lead to a real change in trajectory for this 8-year-old boy. At a minimum, the Mom felt heard and seen in her struggles to provide a healthy life for her son and the child picked his own goal for his health that his Mom could stand behind and support.

Some might argue that a physician’s personal struggles have no place in the exam room. Self-disclosure of any personal information can be deemed unprofessional or detracting from the focus on the patient and their own struggles. Well, that is what I learned in medical school.

But then I thought about my own doctors. Having had breast cancer twice and a couple of chronic diseases as a result of cancer treatment, I’ve seen a lot of doctors in my 39 years. Looking back at all of them, the doctors that I respect the most, and heed the advice of, are the doctors I see as regular humans, not just as doctors. Clinic visits that revealed their humanness, in addition to their intellect, lent them credibility, and quickly. Credibility that no white coat or diploma on the wall or recitation of the evidence could provide. And in fact, doctors that I didn’t view as regular humans with human struggles, I scarcely remembered at all.

Although I don’t always disclose as much as I did in that clinic visit with the 8-year-old boy and his mom, I have been careful to use “we” and “us” when it’s truthful and relevant. I don’t have any long-term outcome data to show this makes a difference. However, I do see an immediate difference in my patient and their family’s faces and the depth of the conversations we have about behavior change. And using “us” and “we” is low tech, free and above all humanizing, not only for our patients, but it’s humanizing for us physicians too. After all, health care is one of the most human of all professions, or at least it can be, when we realize and let our language reflect that we are all in this human endeavor to be well, together.

Jessica Tekla Les is a family physician and can be reached on Twitter @lesjessica.

Image credit: Shutterstock.com

Prev

I saw first hand the ravages of cancer and bankruptcy

June 7, 2018 Kevin 1
…
Next

The man with the fedora in the ICU

June 7, 2018 Kevin 2
…

Tagged as: Pediatrics, Primary Care

Post navigation

< Previous Post
I saw first hand the ravages of cancer and bankruptcy
Next Post >
The man with the fedora in the ICU

Related Posts

  • The patient-physician relationship is in critical condition

    Ryan Enke, MD
  • Is the physician-patient relationship becoming a provider-client one?

    Rene Datta
  • Osler and the doctor-patient relationship

    Leonard Wang
  • Building a bond of trust between patient and physician

    Michele Luckenbaugh
  • More physician responsibility for patient care

    Michael R. McGuire
  • Prescribing medication from a patient’s and physician’s perspective

    Michael Kirsch, MD

More in Physician

  • The tragic story of Mr. G: a painful journey towards understanding suicide

    William Lynes, MD
  • The escalating violence in health care workplaces: a critical problem facing the nation’s health care system

    Harry Severance, MD
  • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

    Howard Smith, MD
  • Why allowing yourself to embrace discomfort is necessary for personal growth

    Jillian Rigert, MD, DMD
  • Unconventional health care, flawed studies, and biases: Navigating the complexities for optimal well-being

    Kara Wada, MD
  • Finding your ideal work-life balance: tips for prioritizing personal life and achieving professional success

    Zahid Awan, MD
  • Most Popular

  • Past Week

    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
  • Recent Posts

    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • Healing trauma and reconnecting: Unmasking the impact of dissociation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why the WHO’s pandemic accord is critical for global health care

      Elizabeth Métraux | Policy
    • The revolutionary Kaiser-Geisinger deal: How health care giants are reshaping the industry and empowering patients

      Robert Pearl, MD | Policy
    • The escalating violence in health care workplaces: a critical problem facing the nation’s health care system

      Harry Severance, MD | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Could Semaglutide Help Curb Addictive Behaviors?
  • 'If the Narcan Isn't Working, Give More' and Other Myths About Naloxone Use
  • CDC: Children's Brain Infections Rose Last Winter, But Remained Rare
  • Inside the Fight Against Burnout Amid the Chaos of War in Ukraine
  • Cardiovascular Risk Models Still Fall Short for Arthritis Patients

Meeting Coverage

  • Cardiovascular Risk Models Still Fall Short for Arthritis Patients
  • De-Escalated Surgery Suffices for Low-Risk Cervical Cancer
  • More Evidence Backs Gout Benefit for Gliflozin Agents
  • Reaction to FDA's Approval of Upadacitinib for Crohn's Disease
  • CDK4/6 Extends Reach Into Early-Stage Breast Cancer
  • Most Popular

  • Past Week

    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Why doctors aren’t to blame for the U.S. opioid crisis [PODCAST]

      The Podcast by KevinMD | Podcast
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

      Althea Halchuck, EJD | Conditions
    • We need a new Hippocratic Oath that puts patient autonomy first

      Jeffrey A. Singer, MD | Physician
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
  • Recent Posts

    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • Healing trauma and reconnecting: Unmasking the impact of dissociation [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why the WHO’s pandemic accord is critical for global health care

      Elizabeth Métraux | Policy
    • The revolutionary Kaiser-Geisinger deal: How health care giants are reshaping the industry and empowering patients

      Robert Pearl, MD | Policy
    • The escalating violence in health care workplaces: a critical problem facing the nation’s health care system

      Harry Severance, MD | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

A low-tech way to improve the physician-patient relationship
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...