Doctor-patient communication
Smiling female doctor consulting with senior male patient and adult daughter in exam room

“Why not?” These two words, along with the question they answer – “Have you considered gastric bypass surgery” – were enough to convince me that my new neurologist was not someone I could fully trust.

I did my research. I knew facts that he did not. Gastric bypass was not a medically safe procedure for me. This doctor’s naive questions signaled that he did not see me as an actual person. His first words were like a “tell” in poker. As opposed to seeing me as a new multiple sclerosis (MS) patient, he first saw me as a fat person in need of surgery. Rather than begin our patient / doctor relationship on a positive note, his words created an almost adversarial relationship where his push is met by my pull. In 5 words, this neurologist created a potential breeding ground for me to resist his medical advice.

Patient adherence to medical recommendations is an essential component to healthy outcomes.  How a healthcare provider speaks to their patients can be the difference between a successful collaboration and continual battle. What used to be called bedside manner is now seen as an important part of getting the patient to follow through on instructions. Maximum health outcomes are dependent on patients actively participating in their care. Proactively choosing to use words wisely is often the key to patient adherence. 

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My Best Physician and Why

Dr. Wilson remains the best physician I have ever had. I chose him out of a list of approved primary care physicians. His photo was not particularly a standout from the other smiling faces. He looked nice and his office location was fairly close. From our very first appointment he spoke to me in a manner that was not only friendly, but respectful. With his tone and word choice he established that this was going to be a partnership with my best health possible as the shared goal. At our first meeting, Dr. Wilson introduced himself. It was nothing long or elaborate. He then invited me to do the same. He met me as a person first. My medical issues and needs flowed from that initial engagement. 

In doing this simple act, he did not give up his role as a doctor and medical expert. He maintained his professionalism at all times. He was direct about test results. He was the only person for whom I made an effort to lower my weight. I succeeded because he knew how to use his words wisely.

Choosing to speak to patients in a collaborative way does not mean pandering or talking down to them. It also does not mean stifling one’s personality. Far from it. It starts with an acknowledgment that a patient is a fellow human being who doesn’t have medical expertise, but is an equal nonetheless. 

As part of his show of humility, Dr. Wilson admitted he did not know something. I was not put off by this because his honesty was refreshing. I knew that he was confident enough to let me see him as someone who did not have all of the answers. It opened a space for us to be partners on my journey to better health. When we spoke about my weight he did it by acknowledging the obvious: I was morbidly obese. He also acknowledged that my impressive blood work did not ameliorate the stress on joints and bones. 

Humility, Honesty and Expertise

By not overstating his concerns, he was able to drop a level of defensiveness about the subject. Dr. Wilson saw me as person who was morbidly obese and not as just morbid obesity. His language was not disease centered. He did not use guilt or shame to emphasize my need to lose weight. He did not lead with gastric bypass without being informed. Dr. Wilson chose a goal and I happily met it. Why did he succeed where others failed? He was able to communicate with me in an authentic and caring way. He inspired me to work toward weight loss because he made us partners in this quest. His words made all of the difference.

I have not been Dr. Wilson’s patient in over 11 years. When I met him I did not know that Dr. Wilson would fundamentally change my life. Of course he gently pushed me in the right direction for my health. His real effect was not that. He embodied a standard of medical care that I carried forward to all of my subsequent medical interactions. I am able to forge better relationships with some providers. With others I can confidently advocate for myself without fear. I have experienced what it is like to have a healthcare provider who was careful with how he addressed me and my illnesses. When words are used wisely they can either promote resistance or inspire patient adherence.