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You just can't talk to some people
In our daily practice routine, we encounter all sorts of individuals with all sorts of styles of communicating. One of our greatest challenges as clinicians is to develop our own style that provides a clear transfer of information in a caring tone that can fit this broad spectrum of individuals we treat.
Reading the personality type of our patient and understanding what methods of reasoning and communication are his or her best fit is an art in itself. I've long taken an interest in learning how best to communicate with different types of personalities because I continue to work at being a better communicator with patients.
Recently I met a patient who came for a consultation for cataract surgery. I read her to be highly intelligent, and I was very fortunately warned by the optometrist who referred her that she had a very stubborn personality and was not open to new ideas.
My discussions with the patient confirmed her stubbornness. When I brought up the subject of refractive lens implants, we talked about their limitations. As I always do, I was very clear that no option can guarantee a patient a life of true spectacle independence. The patient didn't seem to accept this. Instead of nodding and understanding the limitations of technology, as most patients do, she ended our discussion by saying, "So if I pay all that extra money, doctor, I will never need to wear glasses again."
Upon clarifying again the limitations of the lens, the patient repeated her position.
In the end I (fortunately) chose not to offer this patient any refractive option with her cataract surgery. I felt it would be a set-up for disappointment and conflict. Like other similar patients I've treated before, this patient illustrated to me the importance of identifying patients with whom I just can't communicate. How many broken physician-patient relationships have occurred because of a gap in communication? How valuable is it to identify this potential gap before real conflict arises?
This is one of many reasons I feel that every surgeon should spend time personally talking through the consent process with patients prior to refractive cataract surgery. There are some important interactions that just can't effectively be delegated.