Dr. Andrew Wong shared a perfect example that he often uses when teaching a seminar: “When you meet someone who doesn’t speak English well, you end up speaking slower and louder,” he said. “And when they don’t understand, you speak more slowly and more loudly. But you’re not accomplishing anything. And that’s sort of what we end up doing.”
Dr. Wong is an orthopedic surgeon from the Tallahassee Orthopedic Clinic; the “we” he is referring to is other surgeons and physicians, and the workshop he teaches is a Communications Skills Mentoring Program. Designed by Dr. John R. Tongue of the American Academy of Orthopaedic Surgeons, the initiative behind the program is that doctors could sometimes use a little instruction when it comes to improving their communication skills and compassion when dealing with patients.
Sound like a good idea? “It really is,” Dr. Wong agreed, “and especially when you look at the history of how it all came about.” The history dates back to 1998, when the AAOS conducted a survey asking the orthopedists questions about how they perceived themselves, and then asking patients how they perceived the orthopedists. “That’s when we found this huge mismatch,” Dr. Wong said.
After Dr. Tongue created the program, he asked for volunteers in regions all around the country to help present the seminars, with a goal of having a group of instructors who crossed all age groups, nationalities and genders, and Dr. Wong was one of three physicians in Florida who offered his services. He explained the program: “It’s a 4-1/2 hour workshop, and the goal is to give the physicians some very concrete skills that they can use as they talk to patients. We give them actual communication techniques that can help them assess whether a patient understands what they’re saying, techniques to allow them to encourage patients to open up when they’re visiting with them, and ways of trying to increase the likelihood that the patients understand the surgeries they’re going to be faced with and the decisions they’re going to be making.
“So we actually give them a set of skillsit’s not just a philosophical discussion saying, ‘Oh you should listen better.’ We give them techniques they can apply when they’re working with patients to accomplish those things. We do this not just through lecturing, but we also have interactive videos we can use, and we do role-playing so people can actually try to be a patient and see the difficulties with communication. So it’s very interactive.”
To be able to lead these workshops, Dr. Wong had to first take the training class himself. That involved traveling to Connecticut for a week to study the ins and outs of the course, including learning about the research and principles behind the communication techniques, and then learning how to teach the program. Professional actors were hired to play the roles of the patients.
“And then once you finished the training, you had to teach the workshop with somebody who was already certified to teach it. That way you did it with somebody with experience, so you could learn some of the subtleties and nuances and how to apply what you just learned. It was a huge undertaking, and they really put a lot of thought into this. It was a very different experienceit was not something most doctors do, spend five days, six or eight hours a day, learning how to teach communications.”
The program was originally designed to for residents, to encourage them while they were young to include good communications as part of their practice. It was also intended just for orthopedic surgeons, but both of those assessments have changed. Dr. Wong, who has been teaching for about five years, said he believes that last year, more practicing orthopedists took the workshop than did residents; and he himself has presented the program to groups of physicians in other practice areas.
So is the program working? Yes. The survey was repeated last year, and, according to Dr. Wong, a recent article revealed that “in general, we improved in pretty much every category. So the patients’ perception of us in terms of our listening ability and our time spent, and all those other issues, have gotten a lot better.”
Perhaps the Communications Skills Mentoring Program will make those future trips to doctors’ offices a little less intimidating.
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