Have you felt unheard by your doctor?
I felt a longing, as I watched the young nurse’s struggle. Deep inside she was wrestling with expectations to be efficient with her time, while she also felt a call to offer compassion and human relationship. It doesn’t matter that this scene is from fictional world of the BBC Drama Call the Midwife, because it reflected my real experience. In Episode 3 of Season 6 the manager has told all the midwives that they must cut the length of their home visits by half so they can be more efficient with their time – the manager’s goal was to fit in twice as many patient visits. But when Nurse Barbara Gilbert found herself running behind, she really struggled to live with those expectations – it was important to her to spend the time with her patients to support them emotionally as well as medically. And my soul cried, “yes, I want this kind of care!”
I felt so strongly about this scene because, at times, I have felt the sting of a visit that was cut short. My hardest experiences happened when I hoped that the doctor would have answers to why my health was failing, that they would be able to help me heal and improve my quality of life. I came ready to tell them all about what I had been experiencing, everything that I thought was important to my diagnosis. I expected to share ideas and to be active in problem solving. In my most disappointing doctor's visits, I experienced nothing like that. After the doctor came in, they looked at their notes, asked me a couple of quick questions, stated what the next step would be, and as far as they were concerned, that was that. When I tried to ask questions or explore other options, the answers signaled the doctor was closing the conversation; they just wanted to get the job done. And to me it painfully felt like in the doctor’s eyes I didn’t matter as a person.
To be fair: when we hear regular complaints in Canada about the length of wait times to receive care, I am grateful that our public health providers do what they can to care for as many as they can. Even so, I feel sad that efficiency often comes at the cost of human care and compassion – and research shows that this cost is all too common. A recent study in the Journal of General Internal Medicine showed that, on average, doctors listen to patients for 11 seconds before interrupting and directing the conversation. The authors point out that when they don’t take the time to listen, doctors miss the chance to satisfy the needs that are most important to the patient. This is what I sometimes experienced, and this is why I felt rejected at those visits: my priorities were not heard and were not met. If it is normal for doctors to jump in with their solution before hearing the need, it’s no wonder that many patients feel unhappy about their care.
I have a vision that our healthcare providers will learn how important it is to hear patients. The path is a bit of a vicious circle, if you think about it – first doctors have to hear patients to know that they want to be heard. This is why I offer to be a messenger. In my experience doctors often listen to someone like me, an educated colleague who speaks the same language. Fortunately for patients, I also know where patients are coming from.
I commit to building those bridges, so patients and doctors hear one another, and can build a solution together. This is one of my calls, because there aren’t many voices who can bridge the two worlds of patients and academics.