| |
Compassionate,
Humanistic Healthcare Goes Mainstream
How does your
doctor or nurse treat you? If you were to ask them how they feel
about you, what would they say? Will they tell you? Could you
believe them?
Dr. Scott
Diering, in his new book Love Your Patients!, says that it is
crucial for healthcare professionals and doctors to really
understand the three most important things patients need: compassion
and respect, with humility.
Why?
Because unhappy patients will cost them their job, if they get
enough bad patient satisfaction ratings. Because unhappy patients
stay sick longer, and sue more often. And because it is now
mandated by law that medical students pass a test proving
they have decent bedside manners.
Love Your
Patients!
explains the three key virtues of patient care, which every
healthcare professional needs, in order to practice successfully
today:
Compassion
is love from the heart. Compassion is shown by our
empathy, when we minister, and by our attention.
Empathy
is the core of compassion. We must empathize, and truly feel their
pain. We empathize when we:
o
Carefully read our patients feelings, intentions and clues.
o
Acknowledge and respond to these emotions.
o
Use our facial expressions to demonstrate we can feel what they
feel.
We minister
to our patients (not just “deliver” health care at them). We
minister when we:
o
Are supportive and comforting.
o
Get close to, and touch, our patients.
o
Speak personally and say “I” and “we” a lot.
Our
attention shows our patients that they have our time (No
multi-tasking!) We attend when we:
o
Listen to everything, especially their story, and reflect back what
we heard.
o
Make eye contact with our patient and their visitors.
o
Excuse ourselves when our attention shifts, or when we leave them.
Respect is
love from the spirit.
Respectfulness is when we are courteous, when we validate
our patients, and by being honest.
Courteousness
and politeness are indispensable! We are courteous when we:
o
Politely greet people using good manners, calling them Mr. or Ms,
sir or ma’am.
o
Dignify our patients with privacy and strict confidentiality.
o
Behave as a host in our home, and warmly welcome our patients.
Validation
is the core of Respect. We must never let a patient appear
stupid! We validate our patients when we:
o
Allow our patients to save face, no matter what they say or do!
o
Acknowledge all their efforts, and their goals for improvement.
o
Recognize their unique qualities, skills and lives.
Loving
providers are completely honest, and keep their patients well
informed about every step of their care. We are honest when we:
o
Respect our patients’ time, and explain delays in results and
callbacks.
o
Give up control, and let them know their own responsibilities.
o
Admit mistakes!
Humility
is love from the intellect. We are humble when we
translate our jargon, admire our patients, and are
gracious. Translating our lingo takes true humility.
We must
translate all our medical, institutional and technical terms!
Translating means that we:
o
Always use plain English with our patients.
o
Are generous with metaphors and similes to make things concrete for
our patients.
o
Explain our thought processes, decision trees and rationale, too.
Admiring
our
patients is easy when we:
o
Compliment them and their visitors frequently, and thank them for
coming in.
o
Are enthusiastic, and ask some non-healthcare questions about
their lives.
o
Trust our patients to do the right thing, when we leave them.
Being gracious
comes naturally when we:
o
Apologize for any imperfections.
o
Ask and suggest, don’t demand or order, our patients do something.
o
Sit down and smile, whenever possible.
Dr. Diering
plans to make healthcare better. He asks patients and providers to
share their experiences, good and bad. On his website, he has phone
numbers, emails and a response page for feedback!
For more
information on Love Your Patients! and on teaching your
doctor, nurse or healthcare professional about Agape, visit
www.loveyourpatients.org.
For a free
publication, “Ten ways to get your doctor to show they care” email
your request to
sdiering@gmail.com, and include the words “Ten ways”
in the subject line.
YYYYYYYYY
Love
Your Patients!
($17.95) is currently
available from the website, Amazon.com, BarnesandNoble.com and the
publisher, Blue Dolphin Publishing.
For review copies,
interviews or a media kit, call Dr. Scott Diering, 301 620
1588 or email
sdiering@gmail.com.
Paul M.
Clemens, Editor, Blue Dolphin Publishing, Inc. 800 643 0865 or 530
265-6925
bdolphin@netshel.net;
www.bluedolphinpublishing.com
New Book, Love Your
Patients!, Targets the Second Biggest Problem in Healthcare
Today!
What is the second biggest problem in
healthcare today?
Rudeness! Love Your Patients! is
a new book, written for practitioners in every field of health
care. It teaches healthcare providers how to be compassionate and
respectful, with humility, even in the fast-paced pressures of
modern medicine.
Who will care enough to read Love Your
Patients!?
|
Students,
especially medical students, who need to demonstrate compassion
towards patients during the new USMLE test before they can get a
medical license. |
|
Practitioners,
especially those who need to boost their patient satisfaction
scores in order to keep their jobs or their contracts. |
|
Patients,
especially those who need a gentle way to let their doctors know
how rude and unprofessional they have been. |
|
Hospitals and
insurance companies, especially institutions who need to
reduce complaints and malpractice risks, since so much medical
malpractice stems from poor communication. |
©
Students will need Love Your Patients!
Love Your Patients! teaches
students compassionate, humanistic healthcare, the type of care
mandated by a new, required test for medical students: The Step
2 Clinical Skills exam. This test was given for the first time
June, 2004. It is an interactive exam, utilizing simulated patient
actors, where medical students are evaluated on their interpersonal
skills, compassion and ability to communicate with patients (see,
http://www.usmle.org/news/cse/step2csfaqs1103.htm). The federal
government thinks humanistic healthcare and improving the way
doctors interact with their patients is important enough that new
medical school graduates will have to prove they can
communicate and interact nicely before they can graduate from
medical school!
Bernie Siegel, MD,
author of Love, Medicine and Miracles and Help Me to
Heal, said: Medical training
needs to become a true medical education so doctors learn how to
care for their patients rather than treat diseases. Scott
Diering’s book [Love Your Patients!] shows physicians how
to begin the process and incorporate it into their practice of
medicine.
Similarly, Love Your Patients!
will compliment medical training programs that wish to instill
humanism in their physicians and trainees, such as the $3.2 million
dollar Center for the Humanistic Medicine, in Newark, NJ., the
Doctors Kienle Center for Humanistic Medicine at Penn State's Milton
S. Hershey Medical Center,
http://www.hmc.psu.edu/humanities/kienle/index.htm the George
Washington Institute for Spirituality and Health (www.gwish.org),
and the American Medical Student Association's humanistic medicine
section (http://www.amsa.org/humed/humedres.cfm).
©
Practitioners and Hospitals who need improved patient satisfaction
scores will need to read Love Your Patients!
This new book targets the fastest growing discretionary
expenditures in the healthcare industry: Improving patient
satisfaction scores.
Has you or your loved one been
hospitalized or to the doctor’s recently? If so, you probably
received one of those annoying little surveys afterwards. You may
have ignored it, but your doctor won’t. His or her job may be
riding on your answers.
Love Your Patients!
is a new book, whose goal, to make healthcare better for everyone,
may serve to increase the fortunes of those healthcare professionals who apply its
principles.
Doctors, nurses, clinics and all
healthcare providers are increasing their awareness of patient
satisfaction. And for good reason. Patient satisfaction data are
being used as a proxy for outcome data. It’s true: results of
patient satisfaction questionnaires are used as a measure of
quality of healthcare delivered, more so than morbidity and
mortality data, litigation occurrences and death rates.
Why is this important? Because HMO’s and
big insurance companies are rewarding providers who have the best
patient satisfaction data with contracts and bonuses. (See, e.g.
http://www.managedcaremag.com/archives/9904/9904.patsatis.html.)
Love Your Patients! Inc, founded by Dr.
Scott Diering, author of Love Your Patients! and practicing
emergency medicine physician, seeks to offer healthcare providers a
means of increasing patient satisfaction scores, while at the same
time, decreasing litigation risks, and increasing employee job
satisfaction.
Through his book, Love Your Patients!
(2004, Blue Dolphin Publishing, $17.95), his lectures and the
website (www.loveyourpatients.org)
Dr. Diering offers hospitals, clinics and medical centers a cost
effective way to raise patient satisfaction scores.
Love Your Patients!
will help hospitals, clinics and all healthcare providers improve
their patient satisfaction scores. These data, collected by such
giants as Press Ganey, Inc. (http://www.pressganey.com),
are now more important than death rate, malpractice occurrences and
complications data. Patient satisfaction results are being used
to determine hospital and HMO contracts as well as physicians' pay
scale! (See, e.g.,
http://www.managedcaremag.com/archives/9904/9904.patsatis.html.)
Dr Diering says:
“Love Your Patients! reminds
healthcare professionals that what they do and say while they are with their
patients can make a huge difference in that patient’s health and
healing. In the book and lectures, I review 27 concrete actions
which demonstrate Agape, the unconditional love of humankind.
For example, Humility is an important part of Agape, yet this
virtue is too abstract; therefore, I list nine behaviors which
demonstrate humility, including that we translate our
medical jargon for our patients, and translate our thought
processes, too.”
“We are not here to buff up a few
cosmetic changes for the sake of scores. Love Your Patients!
promotes a sincere evolution in how healthcare is delivered in
this country. Simple, but life changing, transformations are
ignited by this book.”
Love Your Patients!
Is being marketed as a cost effective means to improve bedside
manners, and improve patient satisfaction scores.
©Patients
now have a way to tell their doctor or dentist or nurse or other
healthcare provider, “Hey! Pay attention to me! Care about me!”
They can give their provider this book!
Study after study analyzing what patients
need and want from their healthcare provider indicate that patients
just need to know that the provider cares. How do patients judge
who cares? Patients want a chance to talk, and to be heard.
Patients never, ever want to be ridiculed or made to look foolish.
Patients need to have complex medical terms explained in words they
can understand.
Patients who are do not wish to complain,
patients who sincerely believe that their doctor or provider is
skilled and talented, but rude, and patients who
Of course, there are many, many more
qualities that a patient looks for during any healthcare encounter.
That is why Love Your Patients! teaches providers 27
different skills they can use to help their patients feel loved.
When they receive this book as a gift from a patient, they will know
it is a sincere, concerned effort from the patient to help the
provider do what they do, only better.
©Hospitals,
clinics and insurance companies will want Love Your Patients!
as a resource that helps reduce malpractice claims and complaints.
Lawsuits in healthcare are almost random
occurrences. This means that lawsuits are filed for many reasons,
and a medical or surgical problem is only one of those reasons.
Research has demonstrated that providers who are sued more than
their colleagues are more often seen as “distant” or “uncaring.”
The Maryland Board of Physicians new
physician orientation discusses physician complaints:
The most common reason that patients complain to the
MBP is because of perceived arrogance on the
part of the physician. When the patient has endured
a long wait, rudeness at the hands of office
personnel or the physician, or inadequate time with
the doctor, the patient is more apt to attack the
quality of the medical care given.
Patients who perceive their doctor as being
arrogant and uncaring are much more likely to
express dissatisfaction with their medical care and
are much more likely to sue if there is a bad
outcome. |
|
The art of medicine is the art of Agape.
When providers deliver their healthcare with compassion and respect
and humility, they are building a caring relationship with their
patients. This is much more than just applying some technical
intervention at them. When patients feel the richness of Agape,
they are more likely to understand and accept any imperfections in
their care, because they know that their provider is acting with
their patient’s best interest at heart.
Love Your Patients! is
a philosophy of healthcare: The quality of the patient - provider
interaction has a profound impact on a patient’s health, wellness,
compliance and outcome.
Ms. Kitty Lippy, Chaplain,
Washington County Hospital, Hagerstown, Maryland:
I have been totally blessed by
this book. I tell others they need to read this marvelous
teaching tool to make and create in them even a better
healthcare professional…This book is life changing and I will keep it
always at hand. I felt like I was in the most interesting
class at college and this class held my
attention so that I hated when the
bell rang. I have absolutely enjoyed this journey, walking
through these 21 chapters with you. Thank you Dr. Diering for
sharing a wonderful tool that should be in everybody’s library
to continuously be referred to that we never lose the “Art of
Loving Our Patients.”
About the Author
Dr. Scott Louis Diering
is a practicing emergency medicine physician, who also gives
lectures and workshops on patient satisfaction. He currently lives
and works in western Maryland. Before attending medical school at
Wake Forest University School of Medicine, he practiced as a
clinical psychologist. He earned his Master’s Degree in clinical
psychology from the University of North Carolina at Greensboro. Dr.
Diering grew up in New Jersey, and graduated from Rutgers College in
New Brunswick, New Jersey in 1983. He still has many friends and
family in New Jersey, and his New Jersey roots are easily seen in
his language and mannerisms.
Title: Love Your
Patients! Subtitle: Essential
Behaviors That Enrich
the Lives of
Patients and healthcare professionals
Author: Scott Louis
Diering, M.D. Author home: Frederick, MD
Author e-mail:
sdiering@gmail.com Author web:
www.loveyourpatients.org
ISBN:
1-57733-141-9 Price: $17.95
Size: 5.5 x 8.5 Pages: 242
Topic: Healthcare
Bar Code: Bookland EAN
on back cover First Printing: 2,000
Binding:
paper Publ.
Date: May 2004
Love Your Patients!
Book Statistics
Publisher: Blue Dolphin
Publishing, Inc.
P.O. Box 8
Nevada City, CA 95959
Phone: 530-265-6925 .Orders:
1-800-643-0765 Fax: 530-265-0787
Titles currently in
print: 155
Wholesalers: Baker &
Taylor, Brodart, Koen, Ingram, New Leaf, Quality Books
Foreign Distributors:
Dempsey Distributors. Canada Alternative Books. South Africa Deep
Books. United Kingdom Peaceful Living. New Zealand
MAIL:
P.O. Box 8. Nevada City, CA 95959
SHIPPING:
12428 Nevada City Highway. Grass Valley, CA 95945
PHONE:
(530) 265-6925. FAX:
(530) 265-0787. ORDERS:
1 (800) 643-0765
E-MAIL:
bdolphin@netshel.net. WEB
SITE:
http://www.bluedolphinpublishing.com
Endorsements
Bernie
Siegel, MD, author of Love,
Medicine and Miracles and Help Me to Heal, has this to
say about Love Your Patients!:
Medical training needs to become a true
medical education so doctors learn how to care for their patients
rather than treat diseases. Scott Diering’s book [Love Your
Patients!] shows physicians how to begin the process and
incorporate it into their practice of medicine.
Brian J. Browne, MD,
Professor of Surgery and Medicine, Head of Emergency Medical
Services at University of Maryland says:
Love Your Patients!
is the perfect book for medical students, especially students
preparing for the Step 2 Clinical Skills exam. This is an
invaluable, inexpensive and enjoyable resource for students and
trainees at every level.
Robert J Mallin, DDS,
Past President and Founder NJ Academy of General Dentistry; Fellow
and Master, Academy of General Dentistry; Past Pres. Middlesex
County Dental Society; Past Pres./Founder N J Dental Research Group;
former adjunct faculty Pittsburgh School of Dentistry:
What Love Your Patients! proposes
is so simple, so dignified, so proper, and so needed! It has
potential for everyone in the healing/ health professions, e.g.,
nurses, technicians, dentists, everyone. It’s also a good gift, to
be given by people to their health care providers!
Colleen Gallagher, CRNP, BSN, RN,
Orthopedic Nurse Practitioner at R Adams Cowley Shock Trauma Center:
This is a fantastic book! It summarizes
the heart of patient-healthcare professional relations. And it’s great for nurses!
Dr. Diering reminds us to treat the patient first, and the disease
or injury second. This is absolutely indispensable for every advance
practice nurse, nursing student, everyone in the health care fields!
James D. Herbert, Ph.D.,
Associate Professor & Director of Clinical Training, Department of
Psychology, Drexel University, Philadelphia:
A must read for all doctors, nurses, and
healthcare providers! Dr. Diering shows us all how to build bonds
between healthcare professionals and their patients. Unbeatable for medical
students looking to pass the Step 2 Clinical Skills Exam!
Mr. Anthony Stewart, RN,
former Clinical Instructor, University of Michigan School of Nursing
and Transplant Coordinator, Gift of Life:
Finally! An easy to read book which tells
us all exactly what we have to do so as to have happy patients! No
complex theories! No confusing jargon! Just straightforward, useful
information. And it's full of lively anecdotes, too.
Ms. Kitty Lippy, Chaplain,
Washington County Hospital, Hagerstown, Maryland:
I have been totally blessed by this book.
I tell others they need to read this marvelous teaching tool to make
and create in them even a better healthcare professional…This book is life
changing and I will keep it always at hand. I felt like I was
in the most interesting class at college and this class held my
attention so that I hated when the bell
rang. I have absolutely enjoyed this journey, walking through these
21 chapters with you. Thank you Dr. Diering for sharing a wonderful
tool that should be in everybody’s library to continuously be
referred to that we never lose the “Art of Loving Our Patients.”
Interview Questions
for Dr. Diering
What do you mean “love”
towards patients?
Love towards patients means appreciating them as
individuals, above and beyond their health or medical problems.
Relating to them as a person first, then later, as
person with a disease or illness or injury, is the basis for this
type of love. Unfortunately, it is much easier to relate to the
person’s disease or complaint first, and when we do this, we
sometimes forget the person attached to the illness.
For example, when a patient comes to the ER, and
complains of a headache, our natural reaction is to ask a few
questions about the pain (PQRST, the position, quality,
radiations and relations, severity and timing),
but it is also helpful to ask about stressors, and what is going on
in their life. When we learn about the person, and not just the
problem, we can usually find better suggestions for treating the
symptoms.
Love Your Patients!
reminds us to refocus on the individual first, and our relationship
with them, and on their complaints and problems second, while we
build our relationship with them.
Why love?
Because love is big, and has vast potential.
Obviously, we are not talking about romantic love. I
borrow from the ancient Greek. Agape is the quality love we
have for our patients. Agape is the unconditional love of
all humanity.
Healthcare providers who relate to their patients
with love have already started their patients in the healing
process. Agape- type love, and all its associations, makes
it easier to uncover every important point from our patient’s
medical history. Agape love allows providers to formulate
treatment plans that best suit their patients, improving
compliance. And, Agape love makes patients happier.
Our highly technical healthcare environment permits
dehumanization and distance. Practicing healthcare with Agape
re-connects the provider with their patient.
For example, my CAT scan technician’s job is to take
CAT scans. The other evening, we had a very nervous patient who
needed a CAT scan. The technician held my patient’s hand and
looked into her eyes while she explains what will happen in the
test. My patient was more relaxed, held still better, and we got
far superior test results, than had the patient been nervous and
moving around. That technician’s care and concern for our patient
led to better quality results and more accurate diagnoses, and
ultimately, fewer tests. In this case, a few seconds of compassion
translated into a large reduction in healthcare costs.
How do you define Agape
for healthcare providers?
Agape love is an abstract
concept. For our everyday practice of healthcare, we need more
concrete notions. Agape in Love Your Patients! means
to practice healthcare with compassion and respect and humility.
However, even these terms are can be vague.
Therefore, I define compassion in the healthcare
workplace as comprised or three qualities. When we are
compassionate, we behave empathically, we minister to
our patients, and we attend carefully to our patients.
Respect in healthcare means being courteous,
validating out patients, and their efforts, and being
honest with them at all times.
Humility in healthcare (the most forgotten and
perhaps the most important virtue), is manifested when we
translate our medical nomenclature, when we admire our
patients, and when we behave graciously.
What else are you doing to
make healthcare better?
Besides writing Love Your Patients!, I
established a company, Love Your Patients!, Inc. The company has
two main goals:
-
To
disseminate information on ways to make healthcare better. This
is primarily by making the book, Love Your Patients!,
available as widely as possible. We also have a website,
www.loveyourpatients.org, and have information available on
the website, a summary of the book, links to other relevant
websites, and a feedback page.
-
To
learn, from everyone, what else needs to be done to make
healthcare better. We have an email address,
sdiering@gmail.com, and a message line, 301 620
1933 or 1 866 227 8808 access pin 7798. I encourage patients,
providers, family, and aides, anyone who has had any experience
in healthcare, to call or write and let us know about it. We
want to hear about all the good people, all the rude people, all
the nice things and all the horrible things, so we will know
what needs to be done to make healthcare better for everyone.
I also lecture on Agape and love in healthcare. My
lecture schedule is posted on the website, and I am always looking
for other groups to whom I may speak. I keep the lecture lively and
amusing, and I have received good feedback. (Some of the feedback
is posted on the website.)
What do you talk about in
your lectures? Are the lectures just for doctors?
No, the lectures are helpful to anyone who has any
role of interacting with patients. So far, it seems that the nurses
to whom I have spoken enjoy the presentation the most!
In the lecture, I define who is a patient, and who
is a healthcare professional. I define Agape as being comprised of compassion,
respect and humility. I then describe, in detail, the 27 behaviors
which I see as manifesting Agape. I keep the lecture lively, I pace
around and use humor whenever appropriate.
I also have a workshop, for those groups who desire
more practice with the skills I discuss.
I have given these talks to diverse groups, such as
a broad cross section of the hospital, which included kitchen
workers, housekeeping, nurses, clerks, therapists and aids. Since
each one of them has contact with patients, each one of them
benefited from the information I provided.
Why did you write this book?
If you have been to the hospital or doctor or
dentist lately, you may already have an answer.
Although many healthcare providers are pleasant,
friendly and appropriate, many others are in a hurry, rude and
intolerant of their patients. This book is to make everyone who
works with patients better at what they do.
For the nice ones, Love Your Patients! offers
a few suggestions so that they are even better. For the rude ones,
Love Your Patients! will serve as detailed guidebook for all
their interactions.
In some offices or departments, the doctor is the
only nice one. All the other providers, e.g., the registration
clerks, the nurses, the technicians, are the overworked ones, and
hence are curt and seem uncaring. These providers will enjoy
Love Your Patients! a great deal, and it will make their job
more enjoyable.
I have said elsewhere that the second biggest
problem in healthcare today is rudeness. I wrote Love Your
Patients! to eliminate rudeness, apathy and indifference from
healthcare. The stories and cases in the book, which take up over a
third of the pages, involve technicians, paramedics, nurses,
physician’s assistants, and a wide variety of healthcare workers,
demonstrating that we all have some room for improvement.
Why should doctors, nurses,
dentists or any healthcare provider practice with compassion,
respect and humility?
Because patients get better faster and stay better
longer when they are treated with Agape.
Patient outcome, that is, the degree of success of
any healthcare intervention, is closely tied to patient
satisfaction. Research on patient satisfaction and patient outcomes
has consistently shown that the quality of the interpersonal
interaction has a large impact on patient satisfaction.
I interpret these data to mean that providing the
right medication or treatment or operation for a patient is only one
part of any intervention. A balanced and comprehensive therapeutic
regimen begins with a loving, concerned interpersonal relationship.
All other things being equal, the provider who
treats their patients with love have happier patients, who are more
compliant, seek healthcare less often and file fewer lawsuits than
patients who are treated rudely or without love.
Is it true that patients
treated with Agape file fewer lawsuits?
Yes! Lawsuits in healthcare are almost random
occurrences. This means that lawsuits are filed for many reasons,
and a poor outcome is only one of those reasons. Research has
demonstrated that providers who are sued more than their colleagues
are more often seen as “distant” or “uncaring.”
The Maryland Board of Physicians new physician
orientation discusses physician complaints:
The most common reason that patients complain to the MBP is
because of perceived arrogance on the part of the
physician. When the patient has endured a long wait,
rudeness at the hands of office personnel or the physician,
or inadequate time with the doctor, the patient is more apt
to attack the quality of the medical care given.
Patients who perceive their doctor as being arrogant
and uncaring are much more likely to express dissatisfaction
with their medical care and are much more likely to sue if
there is a bad outcome. |
The art of medicine is the art of Agape.
When providers deliver their healthcare with compassion and respect
and humility, they are building a caring relationship with their
patients. This is much more than just applying some technical
intervention at them. When patients feel the richness of Agape,
they are more likely to understand and accept any imperfections in
their care, because they know that their provider is acting with
their patient’s best interest at heart.
Do these principles apply to
family and visitors, too?
Absolutely. Love Your Patients! teaches us
that family and visitors are to be treated as patients, too, albeit
patients who are concerned about their loved ones’ health, not their
own. All the principles of behaving compassionately and
respectfully and humbly apply equally to visitors, family, clergy,
and anyone who has any concerns for the sick individual.
In my practice in the emergency department, there
are a huge number of visitors and family of all types, calling and
coming in with their loved ones. I treat each one of them with
compassion and respect and humility. Further, there are plenty of
people who are both healthcare professionals and concerned visitors. When
the social worker is involved in a case of domestic abuse, when the
police bring in an intoxicated criminal, or when group home workers
bring in one of their residents, these people have the role of both
provider of care, (or patient advocates) as well as concerned
visitors, who need to be kept informed about the health and medical
condition of their “patient.”
Is your book, Love Your
Patients!, only for physicians?
Definitely not! There are many excellent nurses,
nurse practitioners, technicians, physician’s assistants, aides,
paramedics, dentists, hygienists, physical therapists, pharmacists,
and all other healthcare specialists who can benefit from, and
improve their practice, by behaving with Agape. Virtually
anyone who has contact with patients, in any environment, will do
their job better, and enjoy their job more, when they practice their
healthcare with Agape.
I am actively working on getting this book to be
standard reading for everyone coming into any field of healthcare.
I sincerely believe that the delivery of healthcare, at every level,
by every provider, will be better when we all color our actions with
the soft warmth of Agape.
Are you the only healthcare
provider who thinks this way?
Absolutely not! I have developed this philosophy of
healthcare by watching many, many healthcare professionals over the years. I have
noticed that patients who were treated by caring, loving
professionals tended to do better, and have fewer problems, over
time.
Without a doubt, in general, nurses are far more
advanced in the art of Agape, than are physicians. I suspect
this has to do with the fact that the profession of nursing is
grounded in the belief that the quality of the nurse-patient
interaction is a fundamental component of their delivery of
healthcare. Unfortunately, more and more nursing is becoming
technically oriented, and complex machinery tends to separate us
from our patients. That’s why I endorse nurses reading this book as
well!
Amongst physicians, clearly Dr. Bernie Siegel and
Dr. Hunter “Patch” Adams have done more to advance this philosophy
of healthcare than I could ever hope to do. Dr. Siegel has authored
many books on health and wellness, as has Dr. Adams. Interestingly,
both of them are so devoted to improving the interpersonal quality
of healthcare that they have organizations supporting their goals.
However, in my practice of emergency medicine, I see
many patients in the emergency room who are upset with their doctor
or provider. I frequently have patients ask for referrals to
physicians or healthcare professionals who think and act the way I do.
I believe that the first step in a health and
healing is a good relationship with your doctor, nurse, or other
provider. It is the job of the healthcare professional to establish
that respectful, nurturing relationship.
Can doctors and other
healthcare professionals do their complex tasks and at the same time act with
Agape?
Certainly! One of the reasons medical and
healthcare training tends to be so long and complex is so that we
become comfortable and at ease with the difficult tasks our patients
need us to perform. However, with very few exceptions, there is
always time to build rapport and trust with our patients prior to
any sophisticated interventions, detailed interviews or complicated
decision making.
The purpose of practicing with Agape is so we
know our patients better, have a better understanding of their
needs, desires, limits and goals, and can tailor our recommendations
to suit them best.
For example, there are many ways to offer treatments
for adult onset (or Type II) diabetes. We can prescribe pills,
insulin injections, dietary changes, exercise or a combination of
any of these. What is the best intervention? Only the patient and
their provider, working together, can determine that.
Patients do not come with signs or waving flags
indicating which treatment is best for them. The only way we can
determine how best to care for someone is to ask questions about
them, gain their trust, and admit our own limitations.
What is more important,
scientific knowledge or compassionate care?
This is like asking, what is more important, food or
water? They are each very important…essential… to quality
healthcare.
Healthcare providers go through years of training
because our actions, our decisions, directly affect the lives and
health of so many people in our careers. Knowledge, experience and
life-long education are indispensable for the modern provider.
Yet, at the same time, the purpose of all that
training and education is to help make people better, to help
people make medical decisions that will yield happy, healthy
lives. Our healthcare is provided to patients and families, not
diseases. Often these patients and families are worried, anxious or
confused.
All our knowledge, all our experience can only be
useful if our patients trust us and are willing to listen to our
advice. That trust comes when we are compassionate, interested,
humble teachers, who share what we believe to be important in a
respectful and loving manner, with the sincere goal of helping our
patient.
Is there time to
practice love in healthcare?
Yes. Although it seems that Agape and
compassionate care would take longer for the provider, in reality,
less time is spent over the ensuing months and years. While
establishing trust and rapport may take a few more minutes in the
first few visits, once that trust is established, our patients are
more compliant, require less follow up, and utilize less medical
services. This was actually shown in a study in Great Britain!
Therefore, while it will take more time to ask your
patients about their job or their military experience or their
grandchildren, in the long run, that time yields vast benefits to
you, your patients, and your relationship.
What is the purpose of the
new national, required medical students’ test, the Clinical Skills
exam?
According to the United States Medical Licensing
Examination (USMLETM ) website, the purpose of the new
Step 2 Clinical Skills (CS) Exam is to ensure good communication
skills for practicing physicians in this country:
“The ability to communicate effectively with
patients, demonstrating appropriate interpersonal skills, is
essential to safe and effective patient care. Step 2 CS is intended
to ensure that all physicians practicing in the United States,
regardless of country of origin, can communicate effectively with
patients. Carefully developed rating scales, as well as intensive
training in their use, are used by the standardized patients to
assess communication, interpersonal skills, and English speaking
skills…”
In essence, it seems the board is trying to weed out
those students who extremely bad at interpersonal interactions, and
therefore cannot forge a bond with their patients. This is a good
thing. Patients need doctors with whom they can speak comfortably.
Love Your Patients! will
help students master the interpersonal skills necessary to pass the
Step 2 Clinical Skills exam with ease.
Love Your Patients!
teaches skills which will benefit everyone, not just clinicians.
Love Your Patients! allows practitioners comfort and relaxation
with their style of interaction, so that their medical decision
making is not disrupted by any interpersonal problems.
What role does Love Your
Patients! play for medical students?
Love Your Patients! will
make life easier for medical students. I certainly remember my
medical school training, trying to integrate volumes of complex
information into something useful to my patients. Fortunately, for
me, I had a Master’s degree in clinical psychology, and I had
practiced psychology before and during medical school. While the
interpersonal interactions were easy and enjoyable for me, I saw
many of my colleagues frustrated and upset by their inability to
relate to, and communicate with, their patients.
By adhering to just a few of the many simple
prescriptions in Love Your Patients!
students will be able to enjoy their time
with, and learn from, their patients.
In fact, all students in the caring professions will
get more out of their clinical time when they are comfortable and
relaxed in their ability to relate to their patients.
Should patients give this
book to their healthcare provider?
Yes! Any patient who has ever been treated rudely
while at the hospital or office should give this book to the rude
provider. Any patient who can’t find the words to tell their doctor
or healthcare provider about their poor bedside manners should give
them this book. Any patient who loves the quality of care they
receive, but hates the way it is delivered, now has this book to
give to their doctor!
This is the perfect way to tell your doctor, “Hey,
I like you, but I do not like the way you treat me.” Giving this
book is a non-judgmental gentle way to confront someone on their
behavior, and give them a way to improve.
And, by the way, I am holding a contest for
practitioners. The clinician who receives the most copies of this
book as a gift from his or her patients gets a free invitation to
one of my seminars!
How can a patient get a
doctor or nurse to listen to them?
Patients can and should take a role in making their
needs known to their healthcare professionals. How patients do this
depends on their style of interacting, but here are some tips that
may help.
When patients preface a concern, symptom or medical
history fact with a strong or forceful qualifier, the significance
is appreciated by the doctor or nurse. For example, patients can
say something that gets the provider’s attention:
“This is very important to me…”
“I want you to understand exactly how this makes me
feel…”
“These are crucial to me…”
“I absolutely must know what you think of these
symptoms…”
“My most significant concern…”
“What worries me more than anything else…”
“Before I can leave here today, I must have your
opinion regarding…”
Patients definitely need to be cautious in using
medical terminology. While we all like to seem knowledgeable and
well informed on obtuse and complicated topics, such as anatomy and
physiology, when patients use medical terms with doctors and nurses,
the doctors and nurses assume they have detailed knowledge on the
topics. The providers may think the patients know more than they do
know. Obviously, this can lead to the professionals glossing over
some topics, skipping others, and talking in too much jargon about
others.
What can patients do when
their doctor or nurse is in a hurry, or fails to answer their
questions?
This is a very painful topic, but unfortunately,
occurs all too often. In our understaffed and time pressured
workplaces, we healthcare professionals often seem in a hurry, or worse, seem
uncaring or uninterested in explaining things to patients. While
there is no excuse for rudeness, most times rude behavior is really
a misunderstanding which can be remedied. Patients can help prevent
these misunderstandings with their words, their body language, and
their actions.
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State your needs and requirements up front, and frequently
during your time with your provider. (Remember, the squeaky
wheel gets the oil.) For example,
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“I have five questions I need answered right
now, or as soon as possible.” |
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“You said you would do [a specific task].
When will this happen? I need to know.” |
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“I need to know exactly when I will get the
results…tell me when someone will contact me, or who I
should call if I do not hear from you.” |
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Wave your hands about, stand up, make eye contact, and be
animated! It is easier to ignore a person who is sitting
passively in the corner than it is to ignore a dynamic, moving
person! |
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In
extreme circumstances, such as when the provider walks out of
the room while the patient is still talking, the visitors or
patient may need to let their needs be known in no uncertain
terms.
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Step between the healthcare professional and the door. If
the way out of the room is casually blocked, it is much more
difficult for the provider to leave before everything that
needs to be discussed is discussed. |
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Follow the healthcare professional out of the room. While
you should never be a stalker, it may be necessary to let
the provider know how strongly you feel by following them,
and explicitly stating your needs, and asking when
your questions will be answered. |
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What should a patient do
when their nurse, or doctor or other healthcare professional focuses
on the wrong problem, forgets some important information, or fails
to let their patient speak?
Redirect, redirect, redirect. It is common and
normal for a healthcare professional to focus on the most serious problem and
allow the less serious problems to be addressed later. For example,
I will often see patients who have actually been saving up their
problems and concerns until they have several, so as to make a trip
to the ER worthwhile. When I ask, “How can I help?” They begin a
long list of problems. “Well,” they say, “I have chest pains, my
left eye is itchy, my knee gave out on me last week, I have this
rash in my groin, and I get diarrhea once in a while.” This list of
problems is virtually impossible to deal with in one visit, so I
will focus on the most serious, the chest pain. However, if the
chest pain has been going on for 6 weeks, and it’s from a broken
rib, I may be barking up a wrong tree, and something else may be
more important.
Therefore, it’s best for the patient to list their
most serious concern first, and state why it is the most serious
concern. Then, it helps to tell the healthcare professional exactly how many
other problems there are, and to ask their opinion on the
seriousness of each problem. There is no reason to omit any
concerns, because two different problems can be related. But, and
organized, prioritized list is much easier to work with than a
shot-gun blast of complaints.
Quotes from Love
Your Patients!
Caring Communication
Our patients will know
what’s in our heart from the expression that’s on our face. (pg. 27)
Remember, our face, our
hands and our voices communicate our message. Our words are merely
punctuation for that message. (pg. 172)
Arrogance is the first
sign of mediocrity. (pg. 59)
Polite words re-focus
our attention back on the person. (pg. 180)
The burden is on us to
be understood, not on our patients to understand. (pg. 201)
YYYYYYY
Humanistic Healthcare
Empathy: A shared burden
is much easier to carry. (pg. 26)
We are exposed to hurt,
sick, dying, unhappy people all the time. And all of them, silently
or loudly, call for our help. (pg. 12)
Physical distance
permits emotional distance! Therefore, get a little closer! (pg.
31)
Respectfulness can be
thought of as a concern for the other individual’s sense of self.
(pg. 98)
Our patients want to
know that they are in good hands. However, they also want those
hands to be soft, warm and gentle. (pg. 112)
The more you say, “I’m
sorry,” the fewer things you will have to be sorry about. (pg. 133)
True sorrow brims with
compassion and kindness and humility. (pg. 183)
YYYYYYY
Patient Needs
It’s best to offer help
before they have to ask for it. (pg. 46)
While patients often
feel that being a subject for teaching is a silver lining to their
illness, they provide us this service at the risk of becoming their
diagnosis. (pg. 158)
Empty respect does not
warm any hearts. (pg. 188)
The best teachers answer
the questions that are never asked. (pg. 217)
YYYYYYY
Clinical concerns
It appears that Mr.
Moider retreats to the false security of complex medical
nomenclature when he is faced with deep emotional concerns. (pg.
108)
The healthcare setting
is no place for personal prejudices…The quality or our care cannot
be rationed based on our personal feelings. (pg. 169)
I have cared for
patients who had intestinal worms squirming out of their anus. I’ve
met patients who had maggots that filled their leg wound. I once
cared for a man who had roaches scurrying out of his sleeves. Each
one of these patients needed my care. Each one was glad I did not
make a big deal out of their situation.
Patients get better
faster and stay better longer when treated with Agape. (pg. 206)
The art of Agape is the
art of medicine. (Section III)
About
the Author
Dr. Scott Louis Diering
is a practicing emergency medicine physician, who also gives
lectures and workshops on patient satisfaction. He founded Love
Your Patients!, Inc. to make the world a better place.
He currently lives and works
in western Maryland. Previously, Dr. Diering worked in Scottsbluff,
Nebraska, where he was hospital media spokesperson, wrote and hosted
the hospital’s TV segments, and was county Medical Society
president.
Before attending medical
school at Wake Forest University School of Medicine, Dr. Diering
practiced as a clinical psychologist. He earned his Master’s Degree
in clinical psychology from the University of North Carolina
at Greensboro.
Dr. Diering grew up in New
Jersey, and graduated from Rutgers College in New Brunswick, New
Jersey in 1983. He still has many friends and family in New Jersey,
and his New Jersey roots are easily seen in his language and
mannerisms.
Scott Louis Diering, MD
PERSONAL:
Born: November, 1961
Perth
Amboy, NJ
Address: 99 Siegel Ct.
Frederick, Maryland 21702
301 620
1588
Email: sdiering@gmail.com
EDUCATION and
TRAINING:
7/95-6/98 Emergency
Medicine Residency Program
University of Michigan/St. Joseph’s Mercy Hospital
Ann
Arbor, Michigan
7/93-3/95 Neurosurgical
Residency Program
University of Tennessee Health Science Center
Memphis,
Tennessee
(Electively withdrew from program)
6/92-7/93 Internship:
General Surgery
University of Tennessee Health Science Center
Memphis,
Tennessee
1988-1992
Doctor of Medicine
Bowman Gray School of Medicine
Winston Salem, North Carolina
1983-1986
Master of Arts
Clinical Psychology
University of North Carolina at Greensboro
Greensboro, North Carolina
1979-1983
Bachelor of Arts
English and Psychology
Rutgers College
New
Brunswick, New Jersey
LISCENCES AND
Physician and Surgeon
CERTIFICATIONS:
State of Maryland, #0060192
Expires
9/30/04
Physician
State of
Nebraska, #20775
Expires
10/01/2003
Fellow,
American College of Emergency Physicians
Fellow, American Academy of Emergency Medicine
Diplomate,
American Board of Emergency Medicine
Diplomate #410823
National Board of Medical Examiners
Advanced Cardiac Life Support
Advanced Trauma Life Support
Instructor, Advanced Trauma Life Support
Advanced Pediatric Life Support
WORK EXPERIENCE:
Medicine: 6/03-present Emergency Medicine
Physician
Washington
County Emergency Medicine Physicians
Hagerstown, Maryland
6/98-6/03 Emergency Medicine Physician
Regional West Medical Center,
Scottsbluff, Nebraska
6/95-6/98 Medical
Director, Urgent Care
Oakwood
Hospital – Annapolis Center
Wayne,
Michigan
3/95-6/95 Staff
physician:
President’s Island Occupational Medical Clinic,
Memphis,
Tennessee
Psychology: 1988-91 Consulting Psychologist,
Guilford County
Dept. of Mental Health and Mental Retardation, Greensboro, North
Carolina
PUBLICATIONS and
PRESENTATIONS:
Diering, Scott Louis (2004). Love Your Patients! Essential
Behaviors That Enrich the Lives of Patients and healthcare professionals.
Blue Dolphin Publishing Nevada City, CA: 243 pages. ISBN:
1-57733-141-9.
Diering, SL (2004). Patient Satisfaction in the Emergency
Department. Critical Decisions in Emergency Medicine, 18
(12):1-7.
Website:
www.LoveYourPatients.org (2/2003; updated regularly)
Diering, Scott. Pitfalls in Communication! Enhancing Patient
healthcare professional Relations. American Academy of Emergency Medicine, Annual
Conference, New Orleans, February, 2003
Diering, SL and. Bell, WO. (1991) Functional Neurosurgery for
Psychiatric disorders. A Historical Perspective. Stereotactic
and Functional Neurosurgery, 57: 175-194.
Harter, M.R., Diering, S., and Wood, F. B. (1988). Separate brain
potential characteristics in children with reading disability and
attention deficit disorder: relevance-independent effects. Brain
Cognition.7 (1):54-86
RESEARCH:
Emergency
medicine
University of Michigan
Lab
Setup: Hyperbaric Oxygen Therapy and Cognitive Deficits in
Carbon Monoxide Poisoned Rats
Advisor: Robert Silbergleit, MD
Neuropsychology Dept. of
Psychology, UNC-Greensboro
Master’s
Thesis: Event related brain potentials and
attention to strong somatosensory and visual stimuli.
Advisor: M. Russell Harter, Ph.D.
Event related brain potentials and attention in normal,
Reading
disabled and attention deficit disordered children.
(A
series of NIH grant studies).
Advisor: M. Russell Harter, Ph.D.
Behavioral Dept. of
Psychology, Rutgers University
Psychology
Anticipatory contrast in animals.
Advisor: Charles Flaherty, Ph.D.
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