Listening is one of the two fundamental requirements to ensuring effective doctor-patient communication.
Taking ownership of one's role in solving a problem is the other.
This is akin to the doctor and the patient working together as a team to achieve a favourable outcome.
For this to happen, there needs to be a successful information exchange between the doctor and the patient.
Doctors should take the time to discuss a condition and treatment choices to patients. And patients should ask questions, if they are unsure, and share their concerns with their doctors.
This allows the doctor to guide and motivate the patient to adhere to the treatment plan.
I often see this happening in new eczema cases. After I diagnose a patient with the dry and itchy skin condition, I would tell him about the symptoms, and the aim of the treatment and its components, including the role of steroid creams.
Steroid creams have been proven to be effective in combating eczema flares but quite a number of people are worried about being addicted to it. Others fear the cream would harm their health.
Some parents have heard bad things about the continued use of steroids. They tell me they are afraid to use it on their children.
I am glad when they raise this concern because it allows me to correct the fallacies they may have about steroid creams.
They are playing an active part in the consultation and giving the doctor a chance to give them the information they need, to decide whether to use the medication or not.
On my part, I have to take the time to find out what they have heard, address their concerns and correct the fallacies.
Finally, I may need to summarise the answers to their questions and tell them about their care plan again. This is because the patient could have forgotten some of the earlier information, including the big-picture view of the care plan.
What if the parent had kept quiet about his concerns about the side effects of steroid creams, walked out of the clinic and decided not to use the steroid cream?
I have seen this happen many times. When it happens, the child will be the one who suffers as the treatment will likely not be optimal.
The itching and discomfort will not go away without the use of the steriod cream.
And what if I, the doctor, had brushed the parent's concern aside, merely saying that steroids are safe, without explaining why? The parent would hardly be reassured by the brush-off.
Again, this means that the steroid cream will likely not be used and the child's condition will then not be treated optimally.
Aside from demonstrating a lack of empathy, I would also have failed to take ownership of the situation.
As a doctor, I have a duty to pass on my knowledge on the use of the steroid cream to the patient's parent. It is also my duty to address the parent's concerns.
Yet, around the world, it is not unusual to hear of cases where medications are not taken as prescribed, or cases where patients are unhappy about the speed of their recovery because of various reasons.
Even with good communication, realistic expectations and good treatment, unexpected problems can still arise.
When this happens, it is even more important for the doctor and the patient to listen to each other and to take ownership of the problem to solve it together.
It does not help to put the blame on the other party.
The patient should tell the doctor what he is unhappy about, his concerns and his difficulties.
This way, the doctor would be able to find out what went wrong with the original treatment plan. He can then come up with a new plan.
•Dr Soh Jian Yi is a consultant in the division of paediatric allergy, immunology and rheumatology at the National University Hospital.
•This is the last of two articles by Dr Soh on doctor-patient communication.
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