How do I talk to doctors?

October 7, 2009 6:47 PM

How do I talk to doctors in a professional manner?

I work in nursing homes as a speech-language pathologist. This is a professional job which includes a master's degree and 1 year internship. I often have to talk with doctors in order to discuss a patient's progress, especially in the area of swallowing.

I often feel extremely nervous when talking to the doctors. This is partially because they act somewhat short, impatient. Sometimes, it seems that the doctors act downright arrogant and rude, accusatory without allowing for me to talk. I am also worried that I will look foolish, so this increases my nervousness. I often get tongue-tied and choose the wrong words because of my nervousness. (Yes, strange coming from a speech-language pathologist?!?! Hey, I can see my problem, it doesn't mean I can fix it! LOL).

Has anyone else been in this position? How do you handle talking with doctors in a way which allows them to continue to feel "in charge" and doesn't make it sound like you are talking down to them, although you may know more about a particular aspect than they do....and allows them to consider your valuable information?

Maybe I just need to hear stories from others who experience this as well. thank you......

posted by bananaskin to human relations (11 comments total)

It sounds like their arrogance is effectively making you feel inferior to them. YOU ARE NOT. YOU ARE A TRAINED PROFESSIONAL. Why do you need to speak to them so that they feel "in charge" - arn't you just playing to their egos?

I imagine these docs are all men and that you are female? Would it be different if the docs were female? or if you were male?

You are lacking confidence and shrinking in the face of their arrogance which is always a tough situation to be in - it reinforces itself. I know what this feels like, I too often shrink in the face of arrogant "authority", but I am learning to be more assertive and I try not to be deferential, which is my default.

Whenever I have an unsavoury interaction ahead of me I rehearse what I have to say in my mind so I'm absolutely sure of what I'm going to say. Also I get so angry about this kind of sexism and I think about how angry it makes me and that helps me act more assertively.

Anyway, apologies if I've made false assumptions here, but that's my two cents. Good luck!
posted by beccyjoe at 7:38 PM on October 7 [2 favorites]

First of all, try to ignore doctors who are short with you because they're rude and arrogant. Feel free to let it be known to them that you are also skilled, specialized, educated, and intelligent. I've never been in this precise situation, but I guess I don't see the need to let doctors (or anyone else) feel like they're in charge, especially if they are coming to ME for a technical description about something I know more about.

Doctors are just people; treat them like peers and comport yourself like a peer. I think your nervousness will decrease. I used to stammer in high school, but I've become less self-conscious over the years and it's disappeared to the point that I actually like to speak in front of people. Although Toastmasters is for public speaking confidence, maybe you would find some of their resources helpful.
posted by motsque at 7:41 PM on October 7

I found the best thing to do is just stand there and listen. Most of the time they will be somewhat impressed you did not feel the urge to interrupt them. Wait a moment, weigh their response against your questions and then state your concerns in short sentences.

In my experience they appreciate folks who get to the point and leave out the unnecessary details. Afterwards, tell them you appreciate their response, point out their clear thinking where appropriate and prompt them to explain the that which is right or wrong in your thinking.
posted by bkeene12 at 8:19 PM on October 7 [1 favorite]

You know this - but your input about swallowing is very important to proper care. They need to know what your evaluation is. They know this too - they want to be well informed, they're just busy and maybe anxious to get out of there or who knows really. But you have to just summon the courage and communicate.

When I'm dealing with what may be similar I make sure my information is concise and clear. I simply state who I am, who the patient is and what the issue is.

Sometimes I write it in the progress notes too. If your institution has a place for you to document where they can look be sure you utilize that. Then I document that I spoke to Dr. so&so and wrote blaa blaa blaa in the progress notes. If I have trouble finding them I'll send concise text messages with the pt last name, MMR, the issue, my name, my extension. If they act rude I completely ignore that.

The most important thing here is the the information you have about the patient be communicated to the primary team. Take the personalities out of it and think of this as your goal.

Like most things this gets better with practice.

Back up your confidence with the awareness that your knowledge is very important and they need to know it. Afterall they wrote for the speech consult! They want to know what you've assessed.

It's too bad healthcare people are so busy they can be rude to other teams. Try talking to the nurses - hopefully they are nice, but that's not always the case either. I know I appreciate the speech therapist who help me get the patient with aspiration risks off big fat pills. Thanks for what you do.
posted by dog food sugar at 8:39 PM on October 7

Try to use the language of your specialty effectively, and use the actual words. The doctor(s) want the information they seek delivered as concisely as it can be, with nothing left out, of course.

Do not forget that these doctors are people too! I sometimes feel sorry for them (with the difficulties of their professional responsibilities, I personally am glad I don't have to be so accountable for my thoughts/actions!) Imagine them in their underwear, if you must.

There is also the consideration that your patient needs your imput to help them, so be their advocate in every way, which means taking care of business on the communications end .... it might help you when you think these doctors are busy or impatient.

I have been working with some bossy, impatient and demanding docs for many years, but most are not really like that. Just tell them what they need to know, and they will be
easy(er) to work with ....
posted by bebrave! at 8:40 PM on October 7

Hey Beccyjoe.
You really hit it on the head for me. You are correct in everything you say. Yes, it is always different for me when the doctor is a female (rarely). Yes, I am female and they are most always male, and yes, that has a whole lot to do with it. I hadn't thought about the gender aspect until you brought it up. Maybe that is a lot of the problem for me. I do, indeed, have a gender issue with myself, in our society, and in my family of origin. Femailes were 2nd behind men, always. In my family, in my church background, and my immediate society.....interesting. I may have inadvertently/subconsciously taken on that thinking about myself as a female and continue to carry it as an adult. Thanks for bringing that to my attention.
posted by bananaskin at 9:02 PM on October 7

I'm a speech pathologist in a pediatric hospital. I don't personally do swallowing, but I work on multidisciplinary developmental evaluation teams. There's at least one doctor on every team of any number of specialties (developmental peds, neurology, genetics, plastic surgery, you name it). Most of them are wonderful people who let me know that they value my expertise and insight. A few are arrogant jerks. One straight up told me during staffing in front of a room full of disciplines that my findings couldn't possibly be right. I'd never been so mortified.

Here's the thing. There are jerks no matter where you go and they're jerks for lots of different reasons. Maybe they're super busy. Or maybe they're just douchebags. Some doctors - sometimes - get all uppity because even though you studied for three years, they studied MORE and more = better than. Just tell yourself (over and over) that your training was focused in a way that theirs could not have possibly been, and walk into those conversations confident in yourself and your abilities. Be succinct and to the point and be ready to back up what you're saying if they ask for more info or question your judgment. It sucks, but fake it till you make it - if you act wishy washy then you come off as not confident and they'll have reason to second guess you. Take away that reason.

And if you can, try to get to know them as people - not as superiors or whatever - just people you work with who have a different job to do than you. Even the jerk who called me out. He's a good person, and I know that his rudeness is borne out of truly wanting the best for his patients. As well as a complete disregard for my profession :) But I can't change that and I refuse to take it personally.

Good luck!
posted by lilnublet at 9:29 PM on October 7

I know that when i need to feel more professional, I find that I drop my voice so it's lower in tone, and try to project an air of what I would describe as "gracious confidence."

Don't get too wrapped up in the length of your education and in their status and so forth. You have information that they need. Period. They need your expertise. Give it to 'em straight.
posted by desuetude at 9:32 PM on October 7 [1 favorite]

IANA health professional but I am a woman working in a male-dominated environment.

Many of the people I work with are used to direct speech. They will say what they think plainly, whether or not they think I will agree with it. They will not beat about the bush by adding extra little conciliatory phrasings to make me more comfortable with their opinions. They don't say "I may be wrong, but ...".

Thinking about it, this could be viewed as "short, impatient, arrogant, rude" (your adjectives). That may be so, but it's also efficient and straightforward. It's the standard preferred communication style for many people in many environments, and I get on MUCH better with this kind of person if I do the same myself. Sometimes the results of this sound like an argument. This is not a failure! So long as the argument is productive, on-topic and doesn't involve personal insults, it's fine. Two professionals are likely to disagree from time to time, and discussing this plainly is not an indication that you have failed your womanly duties of keeping everybody maximally pleased with themselves 100% of the time.

Sometimes, a person I'm arguing with doesn't like to admit they're wrong; frequently I observe later that the person has in fact taken on board what I've said but just didn't want to say "oh, yes, perhaps you're right" to my face during the initial discussion.

From these people's point of view, they are being direct, clear and to the point; you are perhaps waffling, and your attempts at "allowing them to continue to feel in charge" will be seen as YOU making a clear signal that you have a low status, your opinions are less valuable and you don't have confidence in what you are saying.

Watch one of those reality programs showing a restaurant kitchen in action for a while, if you want to see a group of people working effectively together while being as short, impatient, arrogant and rude as it's possible to be.
posted by emilyw at 12:59 AM on October 8 [1 favorite]

I agree that "short, impatient, arrogant, and rude" often just means "efficient and straightforward".
posted by jeffburdges at 2:05 AM on October 8

I was/am one of those people and I admit I have been short and impatient and *maybe* rude once or twice, but I have also been on the receiving end many times. My advice to you would be to get into "military mode," ie. dispense with all pleasantries and just deliver your valuable information in a clear and succinct manner.

Give your information like a newspaper report. Headline first, then most important background detail, 2nd, etc etc. Be prepared to stop/be cut off/be asked a question at any time point and your report is done. The last thing I/they want to hear in this situation is alot of fluff or unnecessary explanation, and definitely no pandering or apologies.

They may be busy, or jackasses, or busy jackasses, but that's not really your problem. You may not get any immediate gracious thank yous, but over time it will be appreciated and you may even be sought out when they "just want to hear it straight."
posted by bleecker at 4:45 AM on October 8