Ten Verbal Blunders: Conversational Faux-pas to avoid in your practice.

 

        Through the years, I have seen some of the best clinicians instantly lose all credibility when letting a verbal blunder slip into the verbal interaction @ hand. At a glance, what appears to be an honest assertion or an insignificant remark to us, it might not be so to a patient.  

        Moreover, these all too often utilized tongue slip-ups can rob you of your credibility if nota great trusting rapport that you have developed & enjoyed for years with your patients. The following statements or phrases are those culprits alluded to above:

1. “It’s not a big deal”: While the single closure of a wound might not been your very best that day after countless other ones through the years, for the patient, such a statement would be interpreted as if you didn’t take the time or cared for the cosmetic outcome. Your careless linguistic "faux-pas" (statement) basically discounted their trust in your ability @ their professional expectation.

2. “It’s a slam dunk”:  Sure, easy for you to say since you’re not the recipient of an unfamiliar procedure or intervention for an anxious or distrusting individual of the medical industry. Patients like to be informed of all attendant risks…not some or partially. In some cases, even the most remote ones, too. Wouldn't you?

3."You’re making this more difficult than it really is”: Your empathy just went out the window with that negative, reassuring comment –if you thought it was one. Best practice would be to say, “I will do my very best to minimize any pain or discomfort or possible complications”. ‘I/we will get you through this together.

4.“Here it comes, a 'little' Bee sting”: The sight of a needle is anxiety-provoking even in the “toughest folks” or “weekend warriors”. Downplaying the discomfort, even with the best of technique,s doesn’t help anyone under these circumstances. Pain or discomfort should never be “embellished”, downplayed—just be truthful from the outset. Is best if you tell them you will be as gentle as you can be. Again, never say  ”this won’t hurt you”. Instead, you can say, most patients do well after my explanation(s)

5."There’s nothing wrong with...” This dismissive statement simply translates into the patient’s mind that you doubt his/her concern or complaint being legitimate if voiced to you. 

Before closing the door, diagnostically speaking, it might behoove you to do some preliminary testing or investigation. Avoid early diagnostic closure ( aka Anchoring—a medical heuristic ), especially if there could be a potential unexpected or bad medical outcome.

6."Guaranteed, this will...” get better and/or resolve in 2 days…2 weeks… 2 months. Assurances are best left out of discussions; rephrase outcomes or your expectations in terms of probabilities instead. For instance, "my best guess is…” by using this statement,  the patient will be less disappointed if the course of the illness or ailment takes longer to resolve or improve. Plus, if an early resolution comes to play, then you will be seen as a hero—simple as that.

7.” Sorry for the delay, we’re busy today.”  Patients view their time as just as important as yours. If there’s a delay, notify them @ once and explain that you will be late. They will be appreciative if you can reschedule or give an approximate time of seeing them. Saying you’re busy is not as good as saying an impromptu situation caused the delay, thus requiring your immediate attention before seeing the patient. Always introduce or close by stating you appreciate their patience & understanding.

8.” Oopsie”: Not something you want to say when a mishap or an error happens. This word does not mitigate the bad outcome or the unintended consequence, even though you might think so. Be honest and use a direct approach when explaining what went wrong or possibly caused the departure. Stick to honesty. Remember, minimizing things doesn't bode well with people if there was a significant peril or inconvenience they had to go through

9. “I’m the best @ this”:  Based on whose opinion—Consumer’s report? They think not. Perhaps blowing your own horn may come across as pedantic. Probably it is best to be forthright by stating how many X-Y-Z procedures you have done with safe outcomes, which might be more prudent and less arrogant-sounding to their ears. Moreover, it would be best if your supervising attending physician or colleague would endorse you by saying or praising your accolades, even though there’s nothing wrong with feeling you’re the right person for the job or task at hand.

10. “I have nothing ‘ else’ for you…I wished“: Short of a terminal illness, which you can always consider palliative recommendations or hospice care, you must consider exhausting all medical resources and/or venues before uttering this “I/we’re give up” on you. We must keep a balanced perspective (naturally) and accept that we are not to engage in practicing futile medicine, but we must not abandon ship too soon if there’s some significant statistical chance of medical recovery. 

Sometimes another medical perspective is reasonable and needed. Remember, each and every one of these statements, words, or phrases could easily undermine your patient’s trust and ultimately your clinical/professional credibility. Place yourself in your patient’s shoes if you're to be the recipient of these verbal faux pas. You would feel resentful or upset at the very least. Don’t you think?   

So, before you engage your tongue …you must engage your brain to avoid these verbal blunders being part of your day-to-day communication with your patients. 

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It Takes a Village to Advance OTP

 

For decades many U.S. PAs’ have been frustrated with the name-game change that has left us ‘brand less” in the marketplace. Sadly, to this day it remains unresolved to the satisfaction of our community. As if that was not enough, now we’re facing another intra-professional conundrum—the passage and embracement of OTP not only by policymakers at the state level but by some of our very own peers and AAPA sisters organizations. Most of us wonder if this situation will divide our community since over the last few years we have not been able to present ourselves as an united front like our counterparts, the NP’s have done.

Make no mistake about it. This is going to be an intense advocacy fight for our rights and role in the marketplace. If we do not rise to educate legislators, insurance companies  and others, our dream will never materialize and will never become a reality either. Whether you are a novice or a seasoned PA, the truth of the matter is that we need everyone to be involved and engaged.

 With resilience and determination of some state chapters, a handful states have finally recognized OTP or some form of it, naturally this did not happened overnight, but its possible and attainable when everybody commits their time, their skills and resources.  What better example of this than a modernized  legislative act known as  PA 379 in Michigan & the other recent states that have modernized their state PA Practice Acts as well--Wisconsin being one of the last ones. 

How were they able to accomplish such feat? Simple...it was all because they pooled their resources and had a clear vision and were single-minded in this regard/state chapter mission.

I know at times some PAs may feel OTP is beyond their reach. To those, I will remind them this: you have sacrificed and invested significant amount of time, monies and maybe blood and tears. Isn’t your profession/ career worth fighting for? Think about it...you have come along way—you owe it to yourself to be fully recognized for your skills, your professionalism so you can practice at the highest level of your scope of practice recognized by the law.

So don’t stop believing in your professional possibilities, do not allow others in or out of our community dissuade your social, economic & professional destiny by allowing others misperceptions or disinformation stall our progressive advancement in the legal arena. Keep in mind you’re not alone in this quest even though you may find some negativity or apathy among your peers or outside stakeholders.

Our message should be simple: OTP fundamentally is patient-centric care since it increases access to health care services nationwide to all patients. I believe is important to emphasize this along with the longstanding legacy of our quality care provided over five decades. We must share the same best professional advocacy practices.  When we do these things, we become the agents of change in the world like Mahatma Gandhi said in is famous quote. " Be the catalyst in your village" so OTP can be nationwide recognized.

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Rising Medical Malignant Adocacy

 

        Over the last several years, I have noticed a growing number of distrustful and/or confused patients become anxious regarding their laid-out medical management or proposed treatment plans.  And rightfully so, and while the reasons can be many, none could be more detrimental than very opinionated non-APPs. This (unconscious) growing pernicious behavior committed by kindred allied healthcare peers. They reason questioning the established care plan is viewed as patient-centric care when reality may not be in many instances. It saddens & disturbs me greatly to see a soaring schism occurring amongst ourselves. It seems that in our daily advocate care-giving roles, we have started to take our roles of “educators” way too seriously. In other words, we have crossed the lines of being helpful to actually becoming hinderers when providing discrepant opinions of the already prescribed outlined  medical care activities.

        Moreover, when we disparage or disagree with other providers proposed treatment plans we immediately plant the seed of distrust in the patient’s minds. So how can we expect or demand patient compliance? After all, wasn’t it us with our ill-advice, of the treatment intervention that caused the misunderstanding and/or their confusion?

        Case in point, I have witnessed many instances in which a provider inadvertently undermined a surgeon’s proposed surgical intervention by disagreeing with a particular approach and taken the liberty to emphatically recommend a different course. Or even a Respiratory Therapist openly disagree with a pulmonologist’s treatment or drug choices selected. Or simply a nurse suggesting a patient or family that the proposed diagnostic intervention in her eyes is unnecessary or too risky for the patient’s age.

         We must be reserved and cautious when freely “dispensing medical advice” to our patients. It is incumbent in us that we must respect the physician-patient relationship or other providers/consultants recommendations. Sure, there are always exceptions to the rule, but this advocacy style could get many entangled in the legal system. An adversarial system in which an allegation of “practicing medicine” without a license could be easily entertained, considered and brought against the healthcare provider regardless of how well were the intentions at the time behind the advise, the opinion or even the recommendation.

        This unintentional or intentional behavior can have significant negative repercussions from perpetuating a fragmented industry to the already mentioned confusion and distrust due to a divisiveness  of opinion that already gives us a bad name --kind of an “us vs. them” mentality. Patients don’t want to have to choose, under duress, or have any more confusion than they may have had before our divisive advocacy came into play.

        If  individually the same amount of energy & effort was spent getting along and trying to build ONE great, seamless healthcare industry on all fronts, instead of wasting that energy on pettiness, not only everyone would prosper, but our fragmented industry would soar to new levels. Patients would have less angst when entrusting their care, their lives to their healthcare team members. 

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Author's Personal Page

 

        The author of this blog is a Boston, MA born individual who has an extensive healthcare industry background, both industry-related as a Pharmacy Technician during his undergraduate years, and industry-specific as a dually N.C.C.P.A. certified Physician Assistant in Surgery and Primary care after graduating from the University of Alabama—Birmingham Physician/Surgeon’s Assistant Program. Over the past 33 years he  has held  past clinical positions  in Cardiothoracic, General Surgery, & Emergency Medicine, including Cardiology  &  Orthopedics most recently. He holds a Master’s in Science with a Healthcare Administration major from Central Michigan University & a 120-hours Healthcare  Risk Management graduate certificate pursued based on his Health law interest.

        He has been retained and consulted regularly by both plaintiff & defense law firms over the past 25 years. During this time, he has served as both, as a consulting medical reviewer & a PA expert. Plus, he also has lectured/spoken on different Clinical Risk Management (PA) issues throughout the years to various PA based Training Programs. Likewise, he has done the same for lay audiences throughout the years covering a wide range of “Wellness” topics.

        Also, he has been a supporter and associate member of numerous professional clinical &  non-clinical organizations. He has also authored many non-clinical articles, spoken/lectured primarily about  career-related advisory subjects as well  as clinical Risk Management best practices. Currently he is employed as an orthopedic PA  for the past 11 years @ a Trauma I Level center. 

Welcome to this Blog Site --what you need to know about it

 

ABOUT THIS BLOG SITE

As a PA blogger, the purpose of this blog is essentially multifactorial, however, I will focus my comprehensive goals in a more detailed fashion as described below. These will based on my current perception of a much needed additional platform for the Physician Assistant community.

         My focus  is, and it will be about:

• Eliminating PA illiteracy or misinformation and misconceptions in the lay media of the Physician Assistant Profession.

• Reinforcing the PA brand via personal reflective personal advocacy views.

• Solidifying the PA community's role in the various stakeholders' minds.

• augmenting thePA'ss voice in an at times unfriendly marketplace.

• Adding a resource to fellow peers by sharing best practice tips, tools, and resources in their daily practices.

• Sharing experiential observations and experience,s and acquired insights of my PA journey to those considering or entertaining the idea of becoming a PA.