Twenty years as a medical malpractice defense attorney has given me a superpower. I’m an extraordinary translator. In the courtroom, we occasionally hire translators to interpret when a witness speaks a language other than English. They help the jury understand the witness and collect the information they need to make a decision. But we need someone able to translate for the jury when a physician starts speaking “medicine.” This also helps the jury understand and decide.
Early in my career, I realized that my biggest challenge was going to be translation. When I first met with a doctor about a case, they’d talk to me about decelerations, osteomyelitis, or evoke potentials. As soon as they left the room, I’d pull out my Tabor’s Dictionary and try to understand what I’d heard. Once I understood, it was my job to translate for the jury, some of whom did not have a high school education. And I quickly found that the better we were able to translate “medicine” into English for the jury, the more likely we were to win.
We had to overcome the “curse of knowledge.” The premise behind the curse of knowledge is that once we know something, we find it hard to imagine not knowing it. Once you know what decels and variability look like on monitoring strips, you forget what it’s like not to know it. And once you know all about osteomyelitis, you forget that the word is confusing. The curse impacts doctors in the courtroom, and they will lose if they can’t overcome it. But it also impacts doctors every time they talk to patients and their families.
If you can learn to overcome the curse of knowledge, you will win trials, but you will also win more time, better outcomes, better relationships, and less burnout. You’ll be much more likely to win your trial if you’re ever sued. And if you can’t overcome it, you’ll lose.
Doctors struggle with this no matter how hard they try to overcome it. Health care organizations aim for the readability of their educational materials to be no higher than sixth-grade levels.
However, researchers found that only two percent of the materials on the AAOS information website met that standard. And orthopedic doctors aren’t alone. All health care providers have the curse of knowledge, and overcoming the curse takes work and focus.
It has been my work and my focus for over 20 years. And I’ve found a three-step process that helps.
1. Be curious. You’ve got to be curious about the patient, their understanding, and their perspective. We know that doctors often feel like answering patients’ questions can be inefficient and a waste of time. It follows that many physicians wouldn’t be inclined to ask more questions about the patient’s understanding. But this is time well spent. Ask your patients if they understand, but go further and ask them what they understand. See if they can translate what you tell them about their condition or their treatment back to you. And when they can’t (which will happen often, especially as you begin this process), ask yourself how to make it simpler and clearer. It also helps to ask your staff to contribute. Often the people who are most tuned into the patient’s understanding and what would help is the front desk staff. Whether it’s because they spend more time talking with patients or because their life experiences more closely resemble that of patients, they are an untapped resource. Ask them for their help in translating “medicine” into English. You’ll find that all of this curiosity is an investment with a substantial return.
2. Be compassionate. I believe that compassion is seeing things from another’s perspective and then acting on what you see. So once you’ve gotten curious and asked questions about what your patients see and understand, you’re in a much better position to be compassionate.
One of my clients told me a story that illustrates just how important it is to see other perspectives and then act on them. When he was a young doctor, he worked at the VA, and a patient came in with a terrible case of athlete’s foot. The doctor wrote the patient a prescription for foot cream, handed it to the patient, and told him to come back in 4 weeks if the rash hadn’t improved. The patient returned and said to the doctor, “It’s no better than it was, and this stuff tastes awful.” Curse of knowledge, indeed.
This doctor is a friend, and I consider him compassionate and kind. But when you can’t see things through another perspective, you can’t act on them. Perspective comes first. And seeing other perspectives takes time, practice, curiosity, and sometimes even coaching.
Remember that clear is kind and unclear is unkind. The more you can tune into your patient’s perspective and act on what they see, hear and understand, the better your patient and your relationship with your patient will be.
3. Build credibility. In my work, I share a belief triangle that builds credibility. You want stakeholders to believe in you, believe in you, and believe you can help them. The third side of that triangle–believing you can help them–is the most important. When patients believe you can help them, they start to trust you. They start to want to help you help them. And their belief often contributes to their healing.
In order to help your patients believe you can help them, you have to be able to talk to them in ways they understand. You have to be able to explain why they should follow your instructions, stop smoking, optimize their nutrition and minimize their drinking. Explain why and how to take the medication, dress the wound or do the physical therapy; suddenly, they’re much more likely to do it. Credibility always wins.
You overcome the curse of knowledge when you get good at translating between what you know and what your patients know. You become a better doctor, and your patients achieve better outcomes. Your office likely has a plan for when your patients don’t speak English. You know that the language barrier is real, and it impacts your patient’s care. When you recognize that any barrier that stands between you and your patients deserves the same attention and concern, you’ll focus on translating “medicine” into the language your patient speaks. And you’ll have developed another superpower for yourself.
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