Connect versus content: what is more important for practicing doctors?

Flexibility in expression is the skill which has to be learnt for all the doctors. We see some of the doctors who don’t have big degrees have successful clinical practice when compared to few doctors who are more qualified, more experienced and more righteous in treatment. One major difference is the emotional connect , flexibility of expression and empathizing with the patient are the skills well practiced in the clinicians who are successful. We need to understand that the emotional brain has a major role to accept information that is received rather than the logical brain. Many a time illogical things are better accepted because they satisfy the emotional needs of the patients. Doctors who speak straightforwardly without flexibility of expression are generally not liked by the patients and colleagues. They need to gauge the patients emotional status, maturity and acceptability before expressing the content . Major part of expression is by body language , facial features and tonality of expression. Expression to connect is more important than the content. For each and every person, from his emotional point of view two things are important ‘self interest’ and ‘self respect’. Any information that is given to fulfill their self interest without hurting their self respect is accepted by them. On the other hand if information for their benefit is told by hurting their self respect , then they develop negative feelings about the person giving this information and thus acceptability of the advice is rarely followed. In fact before putting forward any information each and every doctor should recheck whether it is in the patient’s interest and more importantly whether it is hurting his self respect. Icing on the cake is if expression is channelized where switching up the emotional gear from not just to hurt him but to evoke a positive emotion should be attempted where they accept with ease and enthusiasm.

Let me give you an example: One patient came to the OPD for a second opinion about a colonoscopic biopsy report which showed well differentiated colonic carcinoma . He asked me what might be the reason for this carcinoma even though I never smoked and drank alcohol and what I should do further? If my answer was : “Eating a lot of red meat and processed food on a regular basis , being overweight and lack of physical activity, are the risk factors which might have contribute to the development of carcinoma”. And then explaining the stages, method of plan of treatment etc, but his logical brain switches off because his emotional brain got hurt ( self respect was poked) by my words or mannerisms of expression. Though I am explaining the best treatment according to the latest evidence to the best interest of the patient, he is not receptive.

Instead of answering in that way, if I could have said — “many lifestyle factors and genetics might have played a role but does not matter because there is a good news and the news is that biopsy is showing low potency cancer and the stage is early wherein we can remove it and throw it away from the body and you will be absolutely normal.” Here I am trying to avoid hurting his self respect in fact I am channeling his negative emotions of uncertainty and fear to positive emotions of hope and enthusiasm. This is a skill to be learnt from case to case basis and conversation to conversation basis.

So flexibility in expression to connect with the emotions of patients is more important than the content of advice.