Walking in Someone Else’s Shoes | Patients and Providers Switch Roles at Medicine X 2015
By Kaitlyn Landgraf
On Saturday afternoon, a group of twenty patients and medical providers gathered together to partake in one of Medicine X’s newest initiatives: “Doctors Are From Mars, Patients Are From Venus,” a brand new communication and role reversal workshop held in Stanford’s state-of-the-art simulation center, in collaboration with Boehringer Ingelheim. The simulation center is usually reserved for medical students, where they interact with actors in exact replicas of examination, operating, and emergency rooms to practice doctor-patient scenarios. But on Saturday of the 2015 Medicine X conference, a group of delegates had the opportunity to role-play as a doctor, debrief on their observations, and share insights on the state of communication (or lack thereof) between health care providers and patients.
The session opened with a short introduction from Dr. Kyle Harrison, a Stanford anesthesiologist who has collaborated on a series of cognitive aids for medical crises with Dr. Larry Chu, Medicine X’s executive director. The workshop, Dr. Harrison said, is about the “exploration of communication.” With the workshop designed as a safe space for open dialogue, he emphasized that there were no necessarily right or wrong answers to any of the questions the group would be considering. Joining Dr. Harrison as workshop facilitator was Dr. Christine Park, professor of anesthesiology from Northwestern University. The simulation center, they emphasized, is a “place for imagining, and most importantly, to learn from each other.”
The discussion kicked off with a question: What are the key components of communication between doctor and patient? Building off of each other’s thoughts and ideas, participants suggested methods for improving communication between doctors, patients, and health care staff. Answers included:
- “Physicians should repeat what they hear from their patients to actively listen.”
- “Patients need to be assertive with their concerns.”
- “Doctors should learn how to let patients speak for more than four seconds at a time.”
- “Eye contact is so important.”
- “It would be great if patients could have an idea of their objectives for their appointment.”
- “For some doctors in certain specialties, every day in their professional life is the worst day in the life of a patient.”
- “We need to remember that time constraints are not always the doctor’s fault; sometimes it’s the health care system.”
Although the conversation could have continued for hours, the workshop next shifted to the simulation examination room to observe two role-play scenarios between a doctor and patient. In the first, Laura Mazer, a Stanford post-doc and surgical education fellow at the Goodman Surgical Education Center, role-played with Melissa Quine, a professional actor trained in playing standardized patients in simulations with medical students. For the workshop participants, they re-enacted a first-time appointment between a primary care physician and a young mother experiencing arm and leg numbness.
After observing the interaction, workshop participants shared their observations. They discussed how doctors should address patients, how to have difficult discussions with patients about bad diagnoses or failed treatments, and how to build rapport and trust quickly while maintaining professionalism and respect.
Then, Dr. Harrison turned the tables on the group: it was time for one of the patients to volunteer to play the role of doctor and diagnose the “patient” with a neurological disease with a five-year life expectancy. The room went silent. Then Charlie Blotner, a brain cancer survivor and Medicine X ePatient scholar, volunteered. Once again, the group returned to the simulation examination room where they observed Blotner, dressed in a white coat and carrying a clipboard, perform several neurological tests with the “patient,” and deliver the bad news. After the role-play concluded, the workshop reconvened to reflect.
“As a patient, I always think from the patient’s perspective, so I’d never stopped to think about what it’s like from the doctor’s perspective,” said Blotner after the workshop concluded. “But sitting there and being in that seat, and seeing the look on the patient’s face, it made me stop and think about how physicians do this every day. I’d never really stopped to think about that before. It really hit me.”
And that’s exactly what Dr. Harrison and Dr. Park were hoping would happen. The purpose of the simulation workshop, said Dr. Harrison, is to “use the power of simulation to allow people to play roles that they normally aren’t able to, so that in a safe space they could explore issues related to patient-doctor commination. We want to be able to give a voice to the patients and a voice to the physicians so they can share their challenges to communicating effectively.” By that standard, the workshop was an overwhelming success.
Kaitlyn Landgraf is a graduate student in the department of journalism at Stanford. She previously attended Thomas Aquinas College and Yale University, where she studied philosophy and religion. Follow her on Twitter at @KaitlynLandgraf.