One of the saddest (and yet not surprising) things I’ve heard over the years in my conversations with chronically ill people is how many people have had negative experiences with medical professionals.
From waiting decades for a diagnosis, receiving no care as their health declined and their lives got smaller, to being dismissed and told that their symptoms are “all in their head”, for many, booking an appointment can be a fraught experience.
This, obviously, isn’t how it should be. But as conversations about “bad doctors” and terrible experiences proliferate online, I can’t help thinking about the conversation I had with GP Dr. Gavin Francis earlier this year in our episode about Rethinking Recovery:
“The longer I’ve been going in medicine, I realised that a huge part of the skill of being a good OT or a good physio or a good doctor is gauging what kind of patient you’ve got in front of you.
What kind of thing do they need to hear? What do they want to hear? What are they capable of hearing?
So just as I’ve got some patients who see me purely as a kind of guardian of scientific knowledge, I’ve got others who see me as just a conduit to specialists. I’ve got others who see me as an arm around the shoulder and a gentle chat. I’ve got others who see me as a kind of collaborative partner. And if you try and be a sort of guardian of scientific knowledge to somebody who wants an arm around the shoulder, you’re going to be the wrong kind of doctor and vice versa.
When I hear about consultations that have gone really, really wrong, in the past, I’ve occasionally been tempted to think, well, that’s been just an incompetent clinician. They haven’t been appropriately sensitive. And increasingly when I hear some of these stories now, I think, actually, maybe they behaved in a way that would’ve worked for one patient or maybe worked for the patient that they saw before them in the clinic, but it didn’t work at all for this patient. And so what they’ve failed in is adequately gauging what kind of consultation this needs to be in order to be effective.
And there are some rubbish doctors and nurses out there, but my experience is, most of them are really highly committed professional people trying their best in a resource-limited system. And they are usually trying their best, but they may often, and regularly I must do this, misjudge the way to approach a particular consultation, which is tragic as you’ve just outlined. If somebody gets set off on slightly the wrong trajectory right at the beginning, it can colour their experience for months or years even.”
As years have gone by, I’ve become convinced that medical communication is a skill - one that we’re not taught. And with medics more overstretched than ever (and many that I know personally have left or are seriously considering leaving the profession), knowing how to maximise limited appointment time is more important than ever.
I wanted to talk to someone who has experience on both sides of the doctor-patient relationship. And with that in mind, I’m delighted to share a chat I recently had with Hannah Barham-Brown, a chronically ill GP and disability activist.
In this episode, we discuss:
The challenges facing doctors in our overstretched, underfunded system
What impact this has on patients
How doctors can create a space for patients to be open, honest and supported
Why we need to have an honest conversation about expectations
How, as a patient, can we get the best out of very short doctor's appointment
How to best communicate what you want from an appointment
How to advocate for yourself
How medics can learn from patient feedback
What to do if you have a negative experience with a doctor
And lots more!
This is an episode for both patients and medics - and I hope you learn as much from it as I did.
To listen, you can just click play at the top of this email, or you can listen on Apple, Spotify, Amazon and Google. If you’d rather read the transcript of the episode, I’ve made that available on my blog.
You can follow Hannah’s work here, and if you have time, I recommend watching her two TedTalks. You can find them here and here.
Thanks to my brilliant producer Philly Guillou at OG Podcasts, to Lucy Dove for the episode art, and to Amit Rai for my intro music.
In case you missed the last couple of episodes of The Rest Room: we talked about navigating work when you live with chronic illness and took a peek inside a chronic illness-friendly workplace.
How to make the most of your medical appointments