In the 15 minutes you spend with your pediatric patients, how do you allocate your time? How much is spent on diagnosing and prescribing treatment? Listening to their story? Does 5 minutes for compassion seem reasonable? That's what was suggested to Vina Pulido, MD. Sharing her conflicted thoughts, Dr. Pulido says,
"One of my colleagues suggested “five minutes of compassion” as a rule-of-thumb. I instantly rebelled. Getting to know a patient’s social history was not only my favorite part of primary care clinic, but also particularly important in patients with so many social obstacles to health care. Yet in a system where less than 15 minutes is allotted for actually speaking with patients, do I have a choice?"
How do physicians allot for their patient's to share stories and express empathy and compassion, when time is at a premium? It's a difficult question to answer, however providing care through a trauma informed lens can act as a framework for physicians. At it's core, trauma informed care ask “What happened to you?” instead of “What’s wrong with you?" Once asked, as Jakub Kaczmarzyk recommends, you need to be open to receiving any response and continuing the conversation:
"A primary care physician’s first question might be: “How do you feel?”—a sentence brimming with subjectivity. She is vulnerable to receive any answer, whether it be “my leg hurts” or “I feel depressed.” As a health professional, she must then diagnose the problem and begin a conversation with her patient regarding treatment."
Sounds simple, right? Continuing the conversation provides its own set of challenges at times. Adjusting your communication style with patients can help. Some ideas for making communication between you and your patients more effective and productive, while still being trauma informed and empathetic (from Dr. Michael Ho):
1. Avoid medical jargon. Remember to break down medical terms, concepts, treatments for your patients.
2. Listen to your patients. Avoid interrupting your patients.
3. Slow down. Avoid rushing with your patients. Use silent pauses to allow your patients to process information or answer questions.
4. Assure understanding. Have patients repeat back your instructions to help ensure their understanding.
5. Be honest. It seem like a good idea to protect your patient's from emotional distress, but honesty is a better idea.
6. Be empathic. Express empathy through tone of voice, facial expressions, word choice, acknowledgement of feelings, etc.