Interpersonal Communication

One of the things I’ve learned during medical school is to maintain complete composure at all times especially in difficult and uncomfortable situations and that conveying empathy from the beginning helps establish rapport. Before medical school, I had more difficulty maintaining composure in highly uncomfortable situations. I also learned that telling the patient that I care and I’m doing the best I can under the circumstances helps diffuse a lot of tension.

One of the examples in the first year of medical school that best exemplifies my slow change is that the I had an incredibly uncomfortable initial patient encounter where the patient was drug seeking and asked for opiates immediately and was unwilling to tell me why they needed the pain medication and how it helped. I immediately got flustered and frustrated because I simply did not know how to proceed from there. I tried to steer the conversation to medications other than opiates but it seems that wasn’t enough and then the patient started to yell at me that I didn’t care about her pain and discomfort. Having some education on the subject I tried to state that possibly a provider specializing in the pain could help more. This just made things worse because they thought I was trying to escape responsibility. The encounter did not end well and I had to get my preceptor to help.

After the interview, my preceptor explained that the tense feelings during the interview and the high energy situation should serve as important lessons to keep your cool and to focus on the situation and to maintain composure no matter what I learned to just explain things truthfully that I am trying to help as best as I can within the constraints of the law. Looking back, it may have appeared that I didn’t have enough empathy towards the patient and that they felt I wasn’t listening and addressing their needs. I was able to continue to work on composure and using language such as “I hear you, I care about what you’re saying, and how can I best help” to make sure that I am communicating empathy.

An emotional self-awareness lesson I filled out for myself and had other people fill out for me early in medical school showed that emotional intelligence was what I needed to work on the most in medical school.

Emotional Self-Awareness- 3

Assertiveness- 3
Self Regard-5
Self Actualization- 3
Independence- 5
Empathy-3
Interpersonal Relationships-4
Social Responsibility-4
Problem Solving- 4
Reality Testing- 5
Flexibility- 5
Stress Tolerance-4
Impulse Control- 5
Happiness- 4
Optimism-4

I continued to work on these skills throughout medical school and got to practice them even more my fourth year. In each of my interviews, whenever a situation escalates, using language that focuses that I’m doing the best I can based on my judgement to take care of the patient seems to help. An example of this is a clinic visit in fourth year at an acute clinic. The patient stated that he was told he could continue to come to this clinic and get opiates even though he wasn’t an established patient. I listened and then I told him I hear him and then tried to explain some of the legal reasons and standard of practice limits. I told him that I’m truly sorry that we can’t give you what you want but that here are some alternatives that we can offer. I was able to keep the situation from escalating as in the example in my first year of medical school by reaching a compromise plan together. This example showed that the work I put into empathy and controlling my own emotions during charged visits helps to reach the best possible course of action. Going into the future, I know that I will be more and more challenged during residency and that I need to keep in mind that the patients are only there because they have a problem and need help. Communication will always be the key feature on making sure the patient understands that everything the physician is doing is bound by best interest of the patients.