The second issue of the medical education marathon is dedicated to the topic of humanity and empathy in the work of physicians
At least once in our lives, we all faced the problem of communication between doctor and patient, or heard such stories from friends. From the obvious “I was not explained my diagnosis and told what to do next” – to more outrageous problems such as “the doctor shouted, kicked out of the ward.” But should all the responsibility be placed solely on the doctor? Is this a systematic problem of the Ukrainian medical system? Or maybe there is a gap in medical education that doesn’t teach doctors to communicate?
The problem of communication between doctors and patients is very deep. It is rooted not only in medical education, but also in the culture of communication in society as a whole. Communication between doctors and patients is definitely important for both parties, because often at the reception we talk not only about treatment, but also about other related things. That is why the question of trust already arises. Therefore, it is important to talk openly about communication problems, if they arise, to understand the reasons and choose the tools to debug.
“Yes, I think this problem exists. In fact, when a person is seriously ill, he will sooner or later learn about his diagnosis. I am now talking about myself and patients like me. It is important that this news is told to you by a doctor who has a good understanding of how to tell people bad news. Exactly how and who communicates with you about bad news has a very strong influence on your further treatment,” said Ivan Zelenskyi, founder of the Drop of Blood Charitable Patients’ Foundation, a member of the group of experts and specialists involved in the Ministry of Health’s Permanent Working Group, advisor to the executive director on access to treatment of the Patients of Ukraine Charitable Foundation.
Tetiana Stepurko, Head of the Medical Education Development Project, shares the results of one of the studies, which will be presented to the public in a few weeks. One of the questions in the questionnaire used in the survey was the question of communication between doctors and patients. “About 60% of patients learn their diagnosis from a doctor. That is, 40% do NOT learn about their diagnosis from their doctor. The fact that this figure is almost a half different is terrifying. So, the patients come home and see the medical report remotely, in the electronic format. They are left alone with this information. This terrifies me as a human. Another question: “How do the other 60% learn about their disease from a doctor?” This also has its nuances. A doctor can say “cancer” and do not explain anything else, or he/she can say that your disease has appropriate treatment. People should leave hospital rescued, but not injured,” Tetiana adds.
Doctor, popularizer of the scientific approach in medicine, blogger Nataliia Leliukh agrees that the problem of communication between doctor and patient exists, and it is not superficial. In addition, it is necessary to talk not only about the negative aspects of the interaction between doctors and patients, but also about the positive ones that are present but often overlooked: “Many private clinics now have the opportunity to leave feedback immediately after admission. So there are almost no good reviews. Positive feedback can only be provided if the doctor asks. This lack of a culture of communication and feedback is related to a culture of communication in general. And it is in the legal field, and in the medical field, and in the field of empathy, and it concerns understanding the other person’s problem,” adds Dr. Natalia. In the best management practices of the world, the presence of the problem signals are the beginning of the search for errors and the precedence of their recurrence. Ivan believes that Ukrainian medical staff should pay attention to how Western society is learning to communicate. Natalia believes that negative attitudes towards doctors are a consequence of mass culture and gives examples of movies and TV series where doctors are mentioned stereotypically. These ideas are then broadcast in society. Thus, the prism through which doctors are perceived is somewhat distorted. It is important to mention burnout among doctors, because those who often see human pain find it difficult to go through this experience. “This issue requires a lot of research and investment. Now, based on my experience, I can say the following. The first thing both doctors and patients should try to understand: medical care should be available 24/7, and the doctor should be available during his working hours. Then, when we adopt this formula, doctors will have time to grow. A little stress gives an opportunity for development, excessive stress stops it,” Nataliia Leliukh comments.
And indeed, everyone needs to learn to enjoy their work, but also from what you live besides work. It is important to teach healthcare professionals to take care of themselves. But it’s also important to learn to do specific things so that your patients experience less pain when interacting with the medical system.
“People who learn about difficult diagnoses often suffer not because of the diagnosis, but because of indifference, rudeness and alienation in hospitals,” said Anastasiia Leukhina, who, along with health care teachers Nataliia Povar and Olena Korotun and other educators, developed the course on humanity and empathy in the work of a health care professionals for their students. In addition, Ms. Nataliia and Ms. Olena already have experience in implementing this course.
“When I was admitted to the intensive care unit in 2018, I was impressed by the professionalism and humanity of the nurses. I was amazed at how they worked! I wanted to help them to show empathy better, so their patients could feel it more. At the time, it seemed to me that it would be very good to practice communication skills that, for example, I and many of my colleagues had not been taught. Suddenly, Anastasia Leukhina offered to create such a course and of course I agreed to participate,” Ms. Natalia shared.
Ms. Olena comments: “It was a revelation for me that communication can really be learned. There are very practical protocols and techniques that teach communication. Our course is primarily for doctors because it makes their lives easier. Communication skills can be learned and this reduces work problems, conflicts, psychological burdens and the burnout. The introduction of such courses in medical HEIs is a responsible thing, as it concerns the issue of academic hours and other administrative aspects. I really want to thank our administration for the support. You see, there was such a demand from students and feedback for this course that as soon as I said that we have a great idea to create a new course, the first thing I was told – let’s do it!”
Communication courses in different formats are present in many medical universities and this course is not new in its format, but it is certainly unique in content. The developers of the course not a number of differences between this course and existing ones. First, this course is very practical, it is based on those methods and protocols that can really be implemented: all methods are based on real cases, cases and scenarios. Second, all the advice available in this course is based on a doctor-patient partnership.
Despite such a positive perception of the course by the administration and medical students, we still see skepticism among doctors who are convinced that all these things do not work in practice. However, when they face certain misunderstandings in communication with patients and learn that there are protocols for how to get out of such situations, they become more positive.
What may be read by patients as indifference may in fact be a simple confusion and inability to communicate. When patients become partners, they take part of the responsibility – they are involved in making decisions about their health and actions.
Thank you for watching this live broadcast with us. You can watch other issues of the medical education marathon at this link → http://mededu.tilda.ws/marathon.