We need to be relatable if we want the consultation to go well.
Why?
Previously, I have defined respect as the establishment of a common language.
Additionally, I have introduced the SCARF approach to gain the patients’ respect.
This acronym: SCARF stands for Status, Certainty, Autonomy, Relatedness, and Fairness.
In this post, I would like to explore the Relatedness-aspect of the SCARF approach.
What happens typically after the examination?
After the physical examination in the mind of the child, the appointment is over.
In their opinion, going to the doctor just means going to be examined and nothing more.
It happens fairly regularly, that at this time, the child is ready to leave, and starts clinging at the door.
We need now to disappoint them!
But of course, the appointment has more aspects than just the examination:
- I need to gain the medical history
(I rely initially on the information provided by the general practitioner to confirm the main question of the encounter) - I also need to obtain any additional information from the parents
- The parents and I have to discuss the treatment plan
Here I must shift my focus
Now, my focus shifts from the child to the parent.
For this transition, I tell the child, “your mummy and I must chat a little”.
Then, I provide the child with an age appropriate toy to play with.
After this, the child is invited to sit at a low table with children’s chairs available in my office.
I want to make transparent to them, that the examination is over.
Why do I hand out the toys just now?
The toys are just handed out by me after the examination. This way they are not initially available to the child.
Otherwise, the toys would distract the child from their role during the examination.
There are two more subtle aspects to me handing out the toys then:
- It increases my status within the encounter
- It provides certainty for the child and parent (“Apparently she knows what she is doing”)
We need to be relatable if we want the consultation to go well.
What is the effect of handing out toys at this time?
This approach allows the child to entertain themselves while the parents and I can focus on our conversation.
The toys need to offer a “task” for the child. Optimally, it should be a toy, that allows the child to solve a riddle or achieve a goal in the time I need for the conversation.
How to relate to the parent during the conversation?
Generally, I start my conversation with the parents by telling them, that I will hand over a personalized written note of the consultation.
I explain my reason for this, as nobody remembers what the doctor tells you.
This blunt statement typically triggers a little sigh or giggle. It is true, but we regularly don’t want to admit it.
We need to be relatable if we want the consultation to go well.
A picture speaks a thousand words
For the explanation phase of the appointment, I use the explanation sheet that is included here below.
I can use this illustration, to clarify the physiology and pathophysiology. It really works better, than a thousand words. It also helps the parents to later recall what I have said and to use it at home to explain the problem and treatment plan to the absent parent.
How does the explanation sheet work for children?
Frequently, I have noticed that now the child leaves the toy. They often approach the parents and me as they want to see for themselves what I am explaining.
If this happens, I briefly pause my explanation and welcome the child to the conversation.
However, I turn and continue, while directing my explanation now also to the child.
This helps me to adjust my style of explanation to the child’s needs.
Overall, when a three-year-old understands my explanation, the chance that the parent understands me becomes higher.
Furthermore, the aim is to be relatable if we want the consultation to go well.
What does it say, when the child joins in to the explanation?
When the child joins the explanation, he or she shows their curiosity to understand for themselves what is going on with them.
They need to be related to the parent and to me as a health care provider.
What do I achieve, by using an empty illustration?
My use of pictures for the most frequent diseases serves several goals at the same time:
- The listener translates my words into their own. Therefore, they are actively engaged in the explanation. This results in a better chance to recall what was said.
- The illustration can be understood regardless any language barrier.
- The illustration can be understood down to a very early age.
- The listener has the illustration available as a mental note, about the principles that have been explained. They can refer to it, when they need to share the information with their partner.
- Also, it becomes much easier, to outline a treatment plan, that has more than one step. With the written note, the patient does not confuse the different phases.
In a nutshell:
Relatedness is granted, by allowing the child to either receive the information themselves or to join in to observe the explanation given to the adult.
Communication lives on comments … fancy to share yours?