July 23, 2017 Liza Swedarsky, MD FacebookTwitterPinterest Honor Health Vow # 4 I Promise to Be an Active Participant in the Patient-Doctor Relationship Good afternoon Ms. B. Wait, how do I interrupt? As I walked into my patient’s exam room this week at the end of a very busy morning packed with procedures, there I stood, waiting over a minute at least for my patient to finish up her cell phone call. She didn’t do so willingly, I had to interrupt her to request she finish the call. “Well, I’ve been waiting for YOU.” Unbelievable. This is the perfect way to establish repoire with your doctor and build a relationship, I thought. The only response I could share was a very honest one, “Well, I apologize that I am 20 minutes late, but I am seeing patients and visits are unpredictable.” I had to remind her we have a no cell phone policy during consultations. As she positioned herself for her exam and procedure, her phone rang again. She immediately sat up, “I have to get this, it’s my Mother.” She answered the call and I waited another half a minute or so before telling her that I would have to move on to the next patient if she needed to take phone calls. “I need your undivided attention.” It had been two years since I’d seen her. She presented in 2015 bleeding after menopause, I had concerns she may have cancer. She had a history of not following through with the plans we agreed upon. She then informed me again, “Well, I’ve waited for you, AND I only have so much time to take care of my business.” Her phone persisted to vibrate loudly throughout the entire 30-minute office visit, interrupting my counseling, as she had to glance over each time. Sadly, this story is more common than one would think. She had no emergency, just didn’t want to miss a call. One may applaud her passive aggression…Pay back for we physicians’ disrespect with regard to your time. However, focusing attention on cell phone calls and texts instead of health care priorities hurts no one but the patient. Smartphones have indeed changed everything about the way we interact and see the world. But they equally remove us from the present moment as we focus on global news or who is in a new relationship on Facebook. I am not sure what text message or phone call cannot wait 15-30 minutes to be addressed. It seems we’ve lost the ability to just be, to sit still and be present. Unfortunately the cell phone obsession finds its way into the exam room all too often. I’ve had to uncomfortably request many times that phones be put away and ask patients if they could refrain from texting until after their visit. With the Internet at your fingertips, your cell phone may help you get through waiting for your doctor, but it will only distract you once your visit starts. The most challenging aspect of competing with texting and phone calls during an office consultation is winning your full attention so that I can explain your diagnosis and develop options and a management plan that you can comprehend. It is our job as physicians to make sure you comprehend your medical diagnoses, address your concerns, and explain a treatment plan in clear terms. Medical terminology is challenging and difficult to understand and remember even when one is fully invested and paying attention. It’s always my distracted patients that inevitably have questions once they are checking out and they have to call me out of another patient’s room to clarify. This was exactly the scenario with Ms. B. Patients leave confused. This is not our goal. The same holds true for physicians. However, there have been times I am expecting a call from the emergency room or a radiologist and I warn my patients in advance that I may have to step out to answer. This is a rare occurrence. You owe it to yourself to be fully present for the time you spend with your physician. It is likely an appointment you have waited for. So be prepared, have your questions ready. Be Mindful. Take time right before your visit to reflect on the goals you would like to discuss. Have your concerns at the forefront of your mind. Write down your questions. Have your menstrual history or symptom diary ready to go. You will survive parting with your cell phone for 15-30 minutes. And I guarantee you will leave your visit with a heightened sense of accomplishment and less frustration. “Feel the energy field of your inner body as you listen. That takes attention away from thinking and creates a still space that enables you to truly listen without the mind interfering. You are giving the other person space- space to be. It is the most precious gift you can give.” -Eckhart Tolle