Power comes from knowledge.
Therefore, the more the patient (with the support of their parents) understands about their condition, the better they are equipped to manage the underlying problem.
Difficulties of power-sharing
For the child to understand what is going on with them, they would need explanations. These clarifications would need to connect with the child’s ability to understand the world.
Therefore, any description of the underlying trouble needs to be given in their language and their mental imaging. The fact that we all create mental concepts of the world, regardless of our age, is a crucial concept for any communication and this is further explored in this post.
Who judges communication?
The quality of communication is here judged by the recipient of the information rather than the sender. Thus, the information must be provided in a way, that is easy to digest for our patient. For this purpose, illustrations of medical concepts are vital. An example in shown here.
With this illustration, the conversation about paediatric ENT-problems is easier, as the patient and their parents can see and understand for themselves, how the cause and the symptoms are related. This helps them to a more profound understanding of the treatment plan as well.
Power comes from knowledge!
And if it is not an ENT-problem?
Every doctor has a set of about 5 to 10 conversations we have in our clinics all the time.
Why not invest some time searching for available images, that would illustrate these concepts and might help the explanations we give most frequently?
These illustrations could include:
- pictures of anatomical concepts
- basics of physiology
- estimated steps of the treatment process
- drawings of early warning signs.
Of course, this is not an exhaustive list.
Power comes from knowledge!
But they forget!
We know that patients forget about 50 -80% of the information we provide immediately.
One way to deal with this issue, is to just not tell them because they will forget anyway.
This would save time, wouldn’t it? It might be faster for us, but this attitude does keep the patient in an uninformed state and contradicts shared decision-making.
This stance leads to the opposite of our goal: Power comes from knowledge!
Why do they forget?
One main reason for the lack of recall is the fact that the patient and their parents remain frequently in a fearful state throughout the consultation.
My eye-opening experience was, when I attended the GP with my elderly mum. We had a pleasant conversation and when we left I thought, “so this is sorted”. But as soon as we arrived in the car-park, I asked myself, “what did we just discuss? What did we agree on?”.
I could not recall the content of our conversation.
The reason was, that I was emotionally too invested in the interaction, that I had no chance to real process the shared information.
Then I thought:
When this happens to me, a medical specialist, who is not frightened in a health-care setting, and who’s IQ is slightly above the average of the general community, … what chance do my paediatric patients and their parents have to take in anything that I need to explain?
None!
How to solve the problem?
Power comes from knowledge!
I take my time to provide the patient and their parents with a written hand-out sheet, as shown here.
This explanation sheet has several purposes:
- it forces me to pause and listen to my patients as I start the conversation with the first three points:
- What do you think about the problem?
- What worries you?
- What would you expect?
- I document this part of the conversation as well as my findings and the plan.
- The patient gets a clear mental picture of what is going on and what the next steps are.
- even if more than one treatment steps are needed
- what I would expect from them on the treatment-path
- what I commit to during the treatment-process
Additionally, the written diagnosis and plan helps the paediatric patient as well as the parent to recall the explanation that has been given.
The provided explanation sheet also allows us to direct the parent to additionally available internet resources. Being realistic, we know that most of the parents will search for alternative information on the internet, whether we want or not. In that case, we better equip them with reliable sources.
In a nutshell:
Power comes from knowledge!
Illustrations, written explanations, and plans tend to empower.
Spoken words alone risk confusing and being forgotten as soon as the patient leaves the room.
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