“There was porn in the call room the first night I slept there.”  The call room is the room where doctors sleep, if they have minutes to catch some sleep, when they are on call. When you’re the first female doctor to ever be on the service, apparently you might find porn in that room.

“I told the partners they could keep the porn if they’d let me paint the walls pink.”

Physicians, like lawyers, are mostly men. However, women are breaking the ceiling in both fields, sometimes slowly but always surely. I recently had the honor of giving a keynote to a group of female doctors, and I listened to the doctors speak to one another with interest. One of the things the young women were yearning for was mentors. If there aren’t many women who have gone before you, it can be a challenge to find a mentor.  And once you’ve found a mentor, what do you hope to get from that person? 

The young women I spoke to had answers. They were looking for accessibility, advocacy, and brutal honesty.  I think these are things we’re all looking for when it comes to relationships– in healthcare, and in life–and maybe we can find them in unexpected places.

1-Accessibility: patients want their doctors to be accessible.  When they’re scared or in pain, they want to know they can reach out to their doctors and get a response. Whether it’s an email, a text, a phone call or a visit, accessibility is sometimes enough to put a patient’s mind at ease, and the body often follows. But doctors need patients to be accessible too. Patients need to show up  to their scheduled visits and more than that, they must be present and attentive. Patients need to be willing to be vulnerable, and let the doctor access the parts of the, not only physical but also emotional, that no one else can see.

2-Advocacy: patients want an advocate.  They need help navigating a complex and impersonal healthcare system. A doctor who is wiling to stand up to an insurance company or a specialist to fight for what is right for her patient is a doctor that patient will never forget. In today’s medical world, doctors need patients to be their advocates as well. Medicine is a business, and for a doctor to do well patients need to advocate for them. When a patient writes a good review on line or refers a good doctor to a friend, everyone gets better.

3-Brutal honesty: patients need doctors to be brutally honest. “Smoking will increase your risk of infection.” “You’ve gained too much weight” are some examples.  More importantly– “I don’t know the answers”  I recently read a Healthgrade review where a patient raved about his doctor’s brutal honesty. Every patient is different, and the level of brutality each can handle may differ, but the honesty piece cannot be sacrificed.  Once again, doctors need the same from their patients.  Patients–and that’s every single person reading this blog–tell your providers the truth. Tell them  if you’re drinking, smoking, taking pain meds, or depressed. Your good health depends on it.

When the young female doctors said these are the things they want from their mentors, the more experienced women said they want the same from their mentees. It’s what many of us are looking for, in all of our relationships. Maybe we all need to mentor one other every day, as best we can. Be available, be on my side, be honest. Tell me the truth–and you don’t have to paint it pink. 

5 thoughts on “Give Me Brutal Honesty – Communication With Patients

  1. WOW, I am over the top brutally honest and not to break ceilings or to paint the waiting room pink but because I am lazy and selfish. I lay it all out, hold nothing back, brutally honest, leaving no guess work for him. My cardiologist is my PCP knows everything and every nook and cranny and what he doesn’t know or isnt his expertise he sends me to a specialist in his network whereby all the computers are connected so even when I see the specialist it pops up on the PCP computer and melds into my PCP records as well so he and his team sees everything, just the way I want it! He is the boss of me and I love it that way and find comfort in knowing all records from specialists or ER visits or anywhere are sent to him and centralized at his PCP team where they monitor my total and complete Healthcare. Voila

  2. The founder of my residency was a male doctor, surgeon turned Family Medicine. I shadowed him into a room once, when he had to present the findings of a biopsy, which turned out to be an inoperable, untreatable malignant mass. The patient had a terminal diagnosis.

    Dr. R stood at the foot of the patients’ bed and said to the patient (no hello, no lubrication), “Mr S, it is time to get your spiritual affairs in order.” The patient knew what that meant. How brutally honest, and insensitive to the fact that the patient may have been an atheist or have had no relationship with a Divine Being. I was stunned. Eventually, I was assigned a young female doctor who was on staff. How different her style. I began to specialize in sitting with dying patients, often going into their homes and staying by their bedsides for hours until they breathed their final breaths. From there, I instructed the family what to do.

    I became gentle and kind. I gave loads of information on what was happening, even defining the Cheyne-Stokes breathing of the dying. Brutal honesty for me meant answering every question and leaving almost no uncertainty in the mind of the patient and their family (sometimes there are no certain explanations). Patience, gentleness, kindness, calm, and being well-educated through constant study. And teaching. This became my winning formula.

  3. I like that you recognized how to be honest without the brutality and bluntness of many in the medical field. I feel that the brutality is used to protect the doctors inner workings. Too much pain and that hurts them.
    However, empathy needs to be exercised just like any muscle.

    Unfortunately not everyone has the ability to see things thru some another persons eyes. Can be taught, many can learn but also need to be sincere.

    I love that you had the strength to join the ranks of the great people!

    Thank you for your insight.

    1. I agree that empathy needs to be exercised, and it may be that not everyone has it. For those who don’t, it’s important to surround themselves with those who do!

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