Effective Physician-Patient Communication and Family Navigation of Medical Problems

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• Cultivating Compassion in Medicine
• The Four Pillars of Medical Leadership
• Preparing for Family Medical Meetings
• The Power of Sitting Down With Patients
• Asking the Crucial Family Question
• Overcoming Intimidation in Medical Settings

Cultivating Compassion in Medicine

Dr. Sanjiv Chopra, MD, states that the first step in improving healthcare delivery is for providers to cultivate compassion. He advocates for a simple technique to achieve this: regular meditation. Dr. Chopra recommends meditating twice daily to automatically foster greater kindness, creativity, and communication skills. He believes compassion is the highest form of wisdom and must be the starting point for every interaction with patients and their families.

The Four Pillars of Medical Leadership

According to Dr. Sanjiv Chopra, MD, patients and families look for four essential qualities in a physician who holds a position of authority. These are stability, empathy, trust, and hope. He references Napoleon's definition of a leader as a "dealer in hope." Dr. Sanjiv Chopra, MD, explains that a physician can instantly build trust and provide relief by personalizing their recommendation. Telling a family, "If this were my relative, I would recommend this exact treatment," creates an immediate and powerful connection.

Preparing for Family Medical Meetings

Dr. Sanjiv Chopra, MD, advises families to proactively prepare for doctor consultations. He suggests holding a family meeting before a physician visit to discuss and write down all questions. This preparation is crucial because the stress of a medical environment can cause people to forget their concerns. Having a written list ensures that no important topic is overlooked during the often brief and intense interaction with the medical team.

The Power of Sitting Down With Patients

A simple yet transformative communication tip from Dr. Chopra is for physicians to pull up a chair and sit down. He learned from his colleague, Dr. Mark Peppercorn, that sitting for five minutes can make a patient feel they received far more time. Dr. Sanjiv Chopra, MD, also recommends that doctors explicitly empower patients and families to write down questions that arise after the visit, promising to address them later. This technique manages expectations and builds a stronger therapeutic alliance.

Asking the Crucial Family Question

One of the most important questions a family can ask a surgeon or specialist is for personalized guidance. Dr. Chopra encourages patients to ask their doctor, "What would you do if this were a member of your family?" This question is designed to elicit a very honest and direct answer, cutting through complex medical jargon and getting to the heart of the best course of action from Dr. Sanjiv Chopra, MD's own perspective.

Overcoming Intimidation in Medical Settings

Dr. Anton Titov, MD, and Dr. Sanjiv Chopra, MD, acknowledge that the hospital environment can be intimidating for families. A professor surrounded by a large team of fellows, residents, and students can make patients hesitant to speak up. This is why the practice of writing questions down is non-negotiable. It serves as a anchor, ensuring that even if a family feels distracted or overwhelmed, they can still advocate for their loved one by referring to their prepared list of concerns.

Full Transcript

Dr. Anton Titov, MD: Renowned Boston liver diseases expert and leadership scholar Dr. Sanjiv Chopra speaks on compassionate care and how to make physician-patient communication more efficient. You study leadership and you have a huge experience in medicine. Leadership is about taking the right decisions at the right time.

Dr. Anton Titov, MD: Let’s take a patient’s perspective. A family or person may encounter a new medical problem in the family or with herself or himself. What can a family do to navigate the medical problem and find the best solution? What are common mistakes to avoid?

Dr. Sanjiv Chopra, MD: That's a great question. Before we even talk about what can the family do, what we as the people in health care delivery need to do is that we need to be very, very compassionate. We need to cultivate compassion.

Dr. Sanjiv Chopra, MD: You can cultivate leadership and you can cultivate compassion by a very simple technique. The technique is meditation. If we meditate on a regular basis, ideally twice a day—once in the morning, second time later in the afternoon or early evening—then these things happen automatically. That compassion grows, kindness grows, creativity grows, fluency grows. We are better communicators.

Dr. Sanjiv Chopra, MD: I would encourage everyone to at least explore meditation. I have a saying: "You should meditate once a day. If you don't have time to do that, you should meditate twice a day." Because then you need it.

Dr. Sanjiv Chopra, MD: We as caregivers need to be very kind. The Talmud says: "Compassion is the highest form of wisdom." Any interaction we have with patients and their families has to start at that level of compassion and communication.

Dr. Sanjiv Chopra, MD: Drawing diagrams, explaining things—sometimes you still see doubt in their mind. Just say to them, "Sometimes this was my relative, if this was my brother, if this was my father, if this was my mother, I would be recommending exactly what I'm recommending to you as a consultant." Once you do that, it immediately—it happened so many times—the family will feel relieved and will trust you.

Dr. Sanjiv Chopra, MD: The most important thing that people look for in somebody with authority, somebody in a leadership position, there are four things: stability, empathy, trust, and hope. Stability, empathy, trust, and hope.

Dr. Sanjiv Chopra, MD: Napoleon was once asked to define a leader. He said, "It is a very simple definition: a leader is a dealer in hope."

Dr. Sanjiv Chopra, MD: One of the best things that patients can do is have family meetings and say, "The doctor will be coming later this morning or afternoon to visit mom, or aunt, or dad—what questions should we ask?" Then write them down, because what happens is when the physician comes, he or she often stands at the foot end of the bed. The family and the patient think he's going to turn on his heels and walk away. He could stand for 20 minutes and they think he spent two minutes.

Dr. Sanjiv Chopra, MD: I learned 30 years ago, maybe even longer, from a colleague of mine, Dr. Mark Peppercorn. He said, "Sometimes you go for rounds, pull up a chair and sit down. You could spend five minutes and the patients will think that you gave them all the time. Before you leave, ask the question, 'Do you have any questions for me?' You know what, you may think of questions as I walk out, or when the family comes to visit you this evening. You have a piece of paper and a pen, write them down. Sometimes I come later this evening or tomorrow morning, we will talk about it."

Dr. Sanjiv Chopra, MD: We need to do that. We need to empower the families to feel very comfortable looking at somebody in authority and asking them questions.

Dr. Sanjiv Chopra, MD: Among the questions I encourage my patients and friends of mine who are dealing with a serious medical issue is to ask their doctor, surgeon, and radiotherapist: "What would you do if this is a member of your family?" That will hopefully give you the right answer and a very honest answer.

Dr. Sanjiv Chopra, MD: This is very important! When I spoke to Professor Lawrence Cohn, a pioneer in cardiac surgery, he said, "Most importantly, you have to ask the doctor all the questions that are on your mind. Don't hold back and ask the hard questions."

Dr. Sanjiv Chopra, MD: Yes, but write them down, because people forget and we all do that. Sometimes you get intimidated with this professor who walks and is surrounded by fellows and residents and students and nurses and there is this whole big group. You might feel intimidated and then you might forget and get distracted.

Dr. Sanjiv Chopra, MD: Write the questions down. It is very important.