Just one thing

In the hilarious Billy Crystal movie, City Slickers, the old cowboy Curly tells Billy that each person has one thing that really gives their life meaning. Sometimes, it only takes one thing to make the difference between feeling lost and rootless and feeling important and fulfilled. Similarly, sometimes it might take just one thing to make our interactions meaningful and our communication more effective.

After giving a presentation on communication at the American College of Physicians’ regional meeting last fall, I was approached by a physician who had found the one thing that had made a difference in her practice. As part of her MOC program, she elected to institute a change in her communication to raise her patient satisfaction scores. She decided to include one final question at the end of each patient encounter to see if it made a difference. So for a period of time, before leaving the exam room she asked, “is there anything else I can do for you today?”

All of her patient satisfaction scores rose to “10.”

Yes, we are rushed. But how long does it take to ask one final question?
Ah, but then we might have to deal with the answer!

In fact, when we fail to listen or hear our patients’ concerns, they generally repeat them until we do. We usually end up dealing with the concern anyway – at a later time when our patient is frustrated and has lost confidence in us and perhaps the medical situation has worsened. How much easier and quicker would it be for us to include this single question from the start?
Imagine the information you might obtain that could improve the accuracy of your diagnosis or your clinical outcomes.
Imagine the time you and your staff would save, avoiding those doorknob conversations or phone calls after the visit.
Imagine the satisfaction you will feel, knowing that your patients realize you care and that they trust you.

So consider what final connection you would like to make with each patient – a question such as, “Is there anything else I can do for you today?” demonstrates your concern, allows the reticent patient to share what is really on his mind, and lets you know that you’re not missing anything.

Just one simple question…with a huge impact.

About Helane Fronek

Over the past 28 years I have had a fascinating and fulfilling career in medicine, initially practicing as a general internist and then as a procedural specialist, caring for patients with vein disorders. As Assistant Clinical Professor of Medicine at UC- San Diego School of Medicine, I’m thrilled to be teaching medical students crucial communication skills along with many other aspects involved in the practice of medicine.
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