Twenty years as a medical malpractice defense attorney has given me a superpower. I am an extraordinary translator. In the courtroom, we occasionally hire translators to interpret when a witness speaks a language other than English. They help the jury understand the witness and gather the information they need to make a decision. But we need someone who can translate for the jury when a doctor starts talking ‘medicine’. It also helps the jury understand and decide.
At the beginning of my career, I realized that my biggest challenge was going to be translation. When I first met a doctor about a case, he would tell me about decelerations, osteomyelitis, or evocation potentials. As soon as they left the room, I pulled out my Tabor dictionary and tried to understand what I had heard. Once I figured it out, it was my job to translate for the jury, some of whom didn’t have a high school diploma. And I quickly found that the better we were able to translate “medicine” into English for the jury, the more likely we were to win.
We had to overcome the “curse of knowledge”. The premise behind the curse of knowledge is that once we know something, we find it hard to imagine not knowing it. Once you know what decelerations and variability look like on monitor tapes, you forget what it’s like not to know. And once you know all about osteomyelitis, you forget that the word is confusing. The curse affects the doctors in the courtroom, and they will lose if they cannot overcome it. But it also impacts doctors every time they talk to patients and their families.
If you can learn to overcome the curse of knowledge, you’ll win trials, but you’ll also win more time, better results, better relationships, and less burnout. You will have a much better chance of winning your case if you are ever sued. And if you can’t overcome it, you will lose.
Doctors struggle with this no matter how hard they try to overcome it. Healthcare organizations aim for the readability of their educational materials to be no higher than sixth-grade levels.
However, the researchers found that only 2% of materials on the AAOS news website met this standard. And orthopedic doctors are not alone. All healthcare providers have the curse of knowledge, and overcoming the curse takes work and focus.
This has been my job and my goal for over 20 years. And I found a three-step process that helps.
1. Be curious. You need to be curious about the patient, their understanding and their point of view. We know physicians often feel that answering patient questions can be inefficient and a waste of time. It follows that many physicians would be reluctant to ask more questions about the patient’s understanding. But it’s time well spent. Ask your patients if they understand, but go further and ask them what they understand. See if they can translate what you tell them about their condition or treatment. And when they can’t (which will often happen, especially early in this process), ask yourself how to make it simpler and clearer. It is also helpful to ask your staff to contribute. Often the people who are most responsive to the patient’s understanding and what might help are the reception staff. Whether it’s because they spend more time talking with patients or because their life experiences are more like those of patients, they are an untapped resource. Ask them to help you translate “medicine” into English. You will find that all this curiosity is an investment with a substantial return.
2. Be compassionate. I believe compassion is seeing things from another’s perspective and then acting on what you see. So once you become curious and ask questions about what your patients are seeing and understanding, you are in a much better position to be compassionate.
A client of mine told me a story that illustrates how important it is to see other points of view and then act on them. When he was a young doctor, he worked at the VA, and a patient came in with a terrible case of athlete’s foot. The doctor wrote the patient a prescription for foot cream, gave it to the patient and told him to come back in 4 weeks if the rash had not improved. The patient came back and told the doctor, “It’s no better than before, and that stuff tastes awful.” Curse of knowledge, indeed.
This doctor is a friend, and I consider him compassionate and kind. But when you can’t see things from another perspective, you can’t act on them. Perspective comes first. And seeing other perspectives takes time, practice, curiosity, and sometimes even coaching.
Remember that clear is nice and blur is mean. The more you listen to your patient’s point of view and act on what they see, hear and understand, the better your patient and your relationship with them will be.
3. Build your credibility. In my work, I share a belief triangle that builds credibility. You want stakeholders to believe in you, believe in you, and believe you can help them. The third side of this triangle – believing that you can help them – is the most important. When patients believe you can help them, they begin to trust you. They start wanting to help you help them. And their belief often contributes to their healing.
In order to help your patients believe that you can help them, you must be able to talk to them in a way that they understand. You need to be able to explain why they need to follow your instructions, stop smoking, optimize their diet and reduce their alcohol consumption. Explain why and how to take medication, dress the wound or do physiotherapy; suddenly they are much more likely to do so. Credibility always wins.
You overcome the curse of knowledge when you successfully translate between what you know and what your patients know. You become a better doctor and your patients get better results. Your practice probably has a plan for when your patients don’t speak English. You know that the language barrier is real and that it impacts the care of your patient. When you recognize that any barrier that stands between you and your patients deserves equal attention and concern, you will focus on translating “medicine” into the language your patient speaks. And you will have developed another superpower for yourself.
Heather Hansen is a communications consultant and lawyer. She can be contacted at Heather Hansen Presents.
Image credit: Shutterstock.com
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