Doctor as Teacher
As a preface, I don’t care what title you have or don’t have, this post is applicable to all healthcare/performance practitioners regardless of how many years of school you sat through.
The term doctor originally comes from the Latin verb docēre which means “to teach”. I want to embrace that root meaning this year in my practice. A great mentor of mine would tell every patient to “ask as many questions as possible because I should be able to explain everything that I’m doing to you and why I’m doing it”. This is an amazing idea for a number of reasons.
First, it opens up the dialogue between the patient and the practitioner. Patients feel that they can communicate with the therapist and that no question is a dumb question.
Second, it forces us as practitioners to know our stuff (or make something up). We all have taken the latter route before, and most likely got away with it, but it would be nice not to have to. It would be nice to be able to have a simple and clear answer for the patient that is based on science, past experience, or some other form of evidence. As ol’ Einstein said, “If you can’t explain it simply, you don’t understand it well enough.” Now I honestly don’t understand much of anything that Einstein proposed so maybe that’s not the best person for the quote, but the idea is good nonetheless. We need to truly understand what we do and why we do it and not just because that’s what we were taught to do in that situation.
Third, patients love being able to understand what’s going on in their bodies and what exactly is being done to make a change. It’s empowering for a patient to understand and it opens the door for them to take the initiative and be part of the process of their own care, the whole “teach a man to fish” idea. Patients who feel like they play a pivotal role in their own progress, and understand why they do, are more likely to do the things that they need to do to get better. This may mean that they do their rehab exercises because they understand the exact muscle imbalances that they have and what needs to be strengthened in order for them to feel better, or they may be more likely to understand why their body needs rest instead of continuing activity, or stick to a new diet as they understand why they need to cut out such and such to feel better.
Unfortunately we as practitioners often talk over patients’ heads. We come from schools where using terms like glucose-6-phosphate dehydrogenase, medial lemniscal tract, and anterior talofibular ligament are commonplace. As I write these words, half of them have red squiggly lines under them because the dictionary doesn’t know that they are, so how can we expect patients to know them?
In my early days of schooling I would throw these terms around left and right with family and friends just so that they would know how smart I was and that they should listen to me when it came to health and performance-related issues. I think we still often do this subconsciously with patients, thinking that if we speak using a ton of academic and sciencey words then they will respect us and trust us. This may be true, but I think that patients have even more respect for a practitioner who can get on their level and explain things simply and clearly. I know I feel this way about my mechanic, and what are we if not mechanics for the human body?
What if we can somehow explain to them that the anterior talofibular ligament is just a strap of connective tissue that goes from the big bump on the side of their ankle to the top of their foot, that it’s important in supporting their ankle and keeping it from rolling outward, and that it’s the most commonly injured structure when we roll our ankle? Maybe for good measure we even show them on their foot where it is and the motion of ankle inversion that stresses (and ultimately tears) the ligament with an ankle rolling. Now the patient is saying “That makes sense… and what was it called again?”
Anterior talofibular ligament doesn’t sound like such a scary term anymore and the patient has a greater level of understanding as to what happened to them with their ankle sprain. They become engaged and now they want to know exactly what we are going to do to help heal the ligament and how our treatment will do it. Another simple and clear explanation for our treatment finished off with what they need to do at home (and why) and we are in business for treating a sprained ankle. The patient limps away (maybe less so than when they came in) feeling good about their treatment and smarter because they learned something.
Without a doubt, we can make patients interested in their own healthcare and increase patient/practitioner relationships which, in the long-term, will benefit both parties immensely. So I am challenging myself this year to, with each patient, “Be able to explain everything that I am doing and why I’m doing it,” and I present this challenge to all of you out there as well!
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