July 15, 2014
I’ve just learnt about Patient Commando (a service set up by Patients to promote Patient storytelling as a method to increase patient engagement in health care) thanks to a promotional comment on the transcript of a speech given by Anna Quindlen at the Jordan J. Cohen Humanism in Medicine Thought Leader Session (that will apparently disappear on the 3rd December so maybe look for it on Google’s Cache).A few stats to start:> 18 seconds. Remember that the next time you visit a doctor. Its how long the average physician gives a patient to tell their story before interrupting. 18 seconds.

> 35,000 words. The new vocabulary a medical student graduates with.

> 6th grade. The average literacy level of the highest needs chronically ill patients.

Is it possible to know “who I am” in 18 seconds? Before the story gets hijacked?

There’s a corny old joke about doctors taking years and years going through school, residency, specialty and then practicing medicine. Patients often wonder when they’re going to stop practicing and doing it for real.

As for patients, when they’re diagnosed with a critical or chronic illness, they don’t get any time to practice. They get thrown into the game right away.

Patients come into the illness journey with the one tool that mankind has been using for thousands of years to find meaning – a story. Each and every patient has a unique story that goes beyond a medical “history”. Its in that story that healthcare professionals learn “who I am”, about relationships, values, stresses, ambitions and culture. All of the things that describe “who I am” and its relevancy to health.

Patients need to feel they’re trusted partners. Healthcare pros build trust with narrative competency. By imaginatively entering into the illness story, they’re able to kick around in the semi-darkness until they get a fair understanding of the whole person. Its not tough to do. We all do it every day. Every time we go to the movies, or read a book or listen to a comedian tell a joke, we trustingly abandon ourselves to someone else’s imagination as they tell us their tale. Combining narrative competency with medical experience applies a fully humanistic approach to medicine.

Patients aren’t shy about telling stories. I’m excited by Dr. Levin’s reason for choosing this speaker “to amplify the patient’s voice” because that’s exactly what we’ve been doing at for the last 3 years. We have the most diverse collection of patient stories in any medium that enrich our appreciation of the lived illness experience. Patients are ready, willing and able to tell their stories when given the opportunity.

Its not hard to “try to be kind”. Here’s a simple act of kindness for physicians that will affect health outcomes: Add another 18 seconds before interrupting.

36 seconds. 30 patients a day. An extra 9 minutes a day.
Could that prevent a misdiagnosis?
Could that avoid an unnecessary prescription?
Could that save a return appointment due to medication non-adherence?
Could that prevent a trip to emergency due to incorrect medication dosage?
Could that save a life?

To the almost 1,300 medical school deans, faculty, students and residents, listening to Pulitzer-prize winning journalist and bestselling author, Anna Quindlen, I ask the following on behalf of all the patients who haven’t won a Pulitzer prize: Please give me 36 seconds to tell my story

Please give me 36 seconds to tell my story

The PatientCommando website seems to result directly from our failure to let Patients help us to document our consultations, but can you imagine if it was just normal for Patients to be taking as much time as they need to tell and document their story before they ever met with a Doctor?

Could you imagine what it will be like when it becomes routine for Doctors to silently listen to all of their Patients concerns BEFORE they meet in the consult room?

Alfred Brendel The word LISTEN has the same letters as the word SILENT


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