Two Questions That Create an Atmosphere of Understanding

Differences are a big part of who we are. With over 80 distinct cultures present in the United States, there’s no knowing who or what the background of your next patient is going to be. Dealing with diverse groups with equity and respect is one of US health care’s most significant shortcomings. 

There is hard evidence proving this point. Infant mortality rate in America is 133% higher in black communities; along the same vein, maternal mortality rate is 223% higher for black women than white women. These are two data points of many demonstrating differences in care outcomes in minority patients. Despite this data awareness, we have yet to close the gap at all over these last decades, leaving persistent differences in care outcomes for similar conditions across diverse groups. 

Dr. Neil Gokal, one of our Diversity, Equity, and Inclusion faculty member here at the Clinician Experience Project, made a powerful statement during our last roundtable discussion: 

“As a human being and species as a whole, the one common aspect we all have is that we are different. Recognizing how that impacts the care we give our patients is huge.”

So huge in fact, that it will benefit the patient’s well-being and promote health equity initiatives to promote lasting inclusion in healthcare. By connecting and understanding in the first visits, future visits will be marked by greater patient trust and minimized mistakes due to ignorance or lack of knowledge. 

Within our Diversity, Equity, and Inclusion Program, Dr. Gokal presents two questions he asks patients to help achieve this kind of connection:

  1. Ask the patient to tell you about them. This seems so simple, but it’s surprising how many clinicians lead with the default question, “what brings you in today?” When you are face-to-face with a patient, there’s a natural opportunity to learn about their life in a time-efficient manner. For example, if he meets with a new patient, Dr. Gokal will ask, “Since we’re meeting for the first time, tell me more about you.” He finds that when he takes the time to ask this question, instead of jumping into the clinical task at hand, a connection is created that can help overcome barriers by understanding where they come from, who they are and what matters to them.
  2. Inquire about their support at home. It is important for clinicians to understand their patient’s living situations and support systems, especially for older patients. Dr. Gokal asks, “Who is your strongest social support?” The most common response Dr. Gokal gets is “no one,” then a moment of silence and sometimes sadness and tears. He will then say something like, “Please tell me more about what that means for you.” This listening gesture opens doors for them to share more and the opportunity to be the person who helps them with the next steps.

When clinicians create an environment in the exam room that enables the patient to partner with their caregiver through open communication and understanding of who they are and where they come from, clinicians can become a powerful source of support and trust for their patients. What are you doing to create an atmosphere of understanding the patient behind the diagnosis? Let us know on LinkedIn or Twitter.

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