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Wednesday, March 04, 2009

Speaking Up to Doctors and Other Authority Figures

Speaking up to someone who is supposed to be an authority is often hard for people. Nowhere is this more evident than in the physician's office.

I work with a lot of infertility patients and I often have to walk them through how to ask questions of the doctor. Most patients have a list of questions they need to get answers to. But often in the face of a authority figure, we are worried that we will be "wasting their time." This may lead to unneeded apologies, "I'm sorry to take up your time, but I wanted to ask you....."

In the first place, apologizing and the rest of the above sentence does take up the physician's time. If you simply ask the question, time will be more effectively used.

There's an article in today's Wall Street Journal about this very issue. The Journal article focuses on the patient who is concerned about cleanliness and public health. The patient quoted in the first paragraph, screwed his courage to the sticking place when he heard his doctor sneeze outside his examining room door and asked, "Are you going to wash your hands before you examine me?"

The patient used courage to ask the question. However, he could have made an even more effective comment by making an assertive statement rather than asking a question. If you ask, "Are you going to wash your hands, etc?" in reality you have put the ball in the physician's court. He could say, "No, my hands are clean."

As a matter of fact, later in this same article another patient said to her doctor: "I have to ask you to wash your hands, according to that sign right there." The doctor, who cursorily washed her hands, responded defensively to that request, stating that she washes her hands at least 15 times a day.

Whenever you ask someone to do something, you give them the power to refuse. If you make a statement claiming your own agenda in the statement, it is much more powerful and takes away the sense that the receiver has a choice.

Example #1:
"I'd feel much more comfortable if you would wash your hands before examining me."

In this example, you make your assertiveness about you rather than the physician. This direct assertive statement expresses your concerns without implying wrong-doing on the part of the physician. In other words, you are taking responsibility for your own worry rather than pointing a potentially shaming finger at the doctor.

Example #2:
"I imagine you have had a overwhelming morning with all those patients in the waiting room, but I would feel much more secure about my own health if you would wash your hands before we start my examination."

The above is an empathic assertive statement in which you connect with the physician by recognizing his/her personal stresses in the day (so that he/she feels more understood and thus more connected with you) before you make your assertive statement.

The Wall Street Journal article points to the Joint Hospital Commission's work entitled: "Speak Up" which is focused on patient advocacy. The web page is worth reading if you are in a physician's care or dealing with ongoing illness.


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