This is going to hurt…a?little!

On a cloudy and windy summer day, I decided to call my old friend Sarah whilst riding by the beautiful Aura riverbank on my beloved electric unicycle (look mom no hands ????). 

A few seconds through our phone call, I discovered that Sarah was definitely not the same.

It wasn’t that COVID-19 dramatically impacted her life as a clinical dentist, but surprisingly she had purchased a small dental office right before the pandemic! (it’s all about timing ?)

Now, she is not only a full-time young dentist but also a leader of an entire practice, handling all admin work and staff management.

“So Tarek, how about you — what have you been up to?” she politely inquired. “It’s been amazing Sarah, I’m currently working on a project really close to my heart.” I responded gushingly in hopes to be heard through the blowing winds. “It’s about communication in healthcare and at the moment I am interviewing both big names in Medicine & Dentistry (#the veterans) as well as patients. The stories I collected were astounding. Oh, Sarah, you would be surprised to know that the most loved and successful clinicians demonstrated more than mere clinical skills and used very deliberate and extraordinary communication skills!”

“Wow Tarek that’s such an important topic.” she empathically commented in her calm tone of voice. At that point, I became silent and felt insecure in my thoughts ??…How would a young dental graduate realize the importance of communication? What would make her even be interested in this dry topic?

She was probably just being nice, because of my enthusiasm…I probably lost her attention during my rant — “close to my heart bla bla bla, communication in healthcare bla bla, more than clinical skills bla!”

A faint voice broke the silence and what I heard next blew my mind! ?? She said:

“Dentistry is a lot more than drilling, filling and billing… I mean placing a filling is literally just placing another filling — they are all the same. But the real challenge is how the patients always look at me. Like I’m this young dentist and they are usually concerned of whether I can manage their medical case or not!

So what I have learnt is to honestly tell my patients everything that’s about to happen beforehand and not afterwards. I inform them that I will do my best to reduce the pain. Because if I explain why they felt pain or discomfort after the procedure then they would interpret it as an excuse! (it’s all about timing ?)

In contrast, ‘beforehand’ is perceived as a sign of expertise and professionalism! It shows your patients that you know exactly what is happening at every point during the procedure. It builds trust and grows their confidence in you, which I believe is what people need to feel before we put our hands in their mouths. People want to feel that they are in the hands of a professional.”

At this point, I was wide-eyed because this reminded me of an interesting study I read back in 2018 that was conducted by Gallup* on the best nurses in the world. As part of their research??, they asked a group of ‘best nurses’ and another group of ‘average nurses’ (control group) to give injections to one hundred patients. Although the procedure was exactly the same, the patients reported feeling much less pain from the best nurses than from the average nurses. But why? What were the best nurses doing to lessen the pain? Did they have some special technique with the needle? Did they apply the disinfectant using a firmer hand or a softer swab?

Apparently not. Apparently it all came down to what the nurse said to the patient right before the needle punctured the skin. The average nurses introduced themselves with a brisk, “Oh, don’t worry, this won’t hurt a bit,” and then plunged in the needle with businesslike efficiency ??

The best nurses opted for a very different approach. They were just as efficient with the needle, but they set the stage rather more carefully. “This is going to hurt a little,” they admitted. “But don’t worry, I’ll be as gentle as I can.” Or in Sarah’s words: “…honestly tell my patients everything that’s about to happen beforehand…”

The best nurses and Sarah knew the injection would hurt, and each of them, in their own style, felt compelled to share that knowledge with the patients. That is known as empathy. Surprisingly, this empathic confession eased the patients’ pain. To the patients, it seemed as though the healthcare professionals were, in some small way, going through the experience with them. They were on their side. The patients felt understood. So when the needle broke the skin, somehow it didn’t feel as bad as they thought it would.

Using empathy is not particularly special. We all have it and call upon it in different aspects of our lives. But it’s clear that the best healthcare professionals are those who extend the use of empathy at work and with their patients. They took the time to actually understand and acknowledge their patients’ worries and needs. Their behavior subconsciously signals genuine partnership. It’s as if they said, “We are on the same team, let’s do this together ??.”

Oh well, it turned out that my dear friend Sarah was not just being empathically nice to me. On the contrary, she had her own challenges and shared a piece of wisdom in the “art of healthcare communication” AKA the one topic that the majority of doctors are NOT educated NOR trained in during medical school. Patient communication and the healthcare experience is ironically left for us doctors to learn through trial and error. I have to admit to my colleagues in healthcare that this is going to hurt…a little!

Note to reader: How about you? Did you have any memorable experiences with your healthcare provider? 

Please feel free to share your thoughts in the comment section below.?

Footnotes

*Gallup is a global analytics and advice firm that helps leaders and organizations solve their most pressing problems. 

In essence, they claim to know more about the will of employees, customers, students, and citizens than anyone in the world. With 35 million respondents in Gallup’s employee engagement database and 90% of Fortune 500 companies using their CliftonStrengths assessment, they probably know a thing or two about talented healthcare professionals.

?? Research excerpt from: Buckingham, M., Coffman, C., 2016. First, break all the rules: what the world’s greatest managers do differently / Marcus Buckingham, Curt Coffman, and Gallup Organization, Simon & Schuster business books.