It’s an impatient quality, but as a physician, wife, mom, friend, etc– I wish everyone could just hear me the first time. With a surgically-oriented personality, I would love to convey things in the most efficient way possible. As in, “Blade!” or “Kelly, please.” So when I’m asked to repeat myself, I feel my inner voice protesting, “This is so inefficient, argh!!”
Usually, if someone repeats him or herself, my inner voice wants to inform them, “I heard you the first time!” But lately, I’ve considered changing my tack. It’s possible the individual repeating himself is trying to tell me something, and I am not quite getting the message. As a new strategy, I’ve tried to come up with a different response each time an idea is repeated. It can serve to smooth the social interaction, and clarify the idea being conveyed. This trick of changing your response came to me when speaking with a family friend suffering from Alzheimer’s disease. Now, I can use it in daily conversations.
So in an attempt to do everything better, I’ve taken to repeating myself more on purpose. Here are some reasons why.
It can help your relationships! For example, if I assume I will need to repeat my message to communicate effectively with my husband, I’ve managed my own expectations. If a message is conveyed the first time, that’s a bonus. Otherwise, repeating myself can be more like a baseline expectation. He’s got other stuff going on, after all, and even if we understand each other, we all get distracted and forget things. Repeating myself is the (modest) price I pay to get an idea from my brain to his.
My little boy is 14 months old, so repeating myself with him is a great way to teach him our language. I repeat words and phrases with as much variability as I can. Sometimes, I’ve realized, repeating myself comforts him. I sing the same lullabies when he’s struggling to settle down for a nap or fighting a diaper change. My singing the few Czech folk songs I know helps him learn a few words and be comforted by a part of his heritage.
Repeating can be a really useful strategy at work, too. Patients and families need plenty of explanation around the diagnoses and treatments we recommend. They need to know the risks and benefits of a given procedure or course of treatment. Before the patient even arrives for a procedure, they are inundated with information on the hospital floor. It’s even more difficult and stressful for patients to assimilate information when they are acutely ill. Therefore, they’re not in the best position to grasp all of the information we provide. This is why repeating yourself can be helpful. Having family or friends at the bedside is also key. It allows for the benefit of repetition, with the help of others who’ve helped to absorb the information.
Every time I repeat myself in a slightly different way, I’m working on my own communication skills. This is really important as an early career physician, but I suspect I’ll be working on these skills for a lifetime.
Depending on the person, and perhaps as a function of my communication style, I find many want to hear more from me, not less. Patients are in a vulnerable place, and they often want the space between us filled with words. It can be soothing to repeat some elements of your consent, or to phrase things in different ways, to help a patient understand. Reiterating, clarifying, and soothing the patient in this way can build trust between you, and can function as a form of social anesthesia.
Fleshing out an explanation with as many simple words, phrases, or descriptors helps to depict the journey a device will take from the groin to the belly in an interventional procedure. Showing a deployed vena cava filter within an acrylic model, or drawing a diagram of the arteries below the knee goes a long way in bridging the gap between a physician and patient.
I recall listening to my attendings as a trainee, marveling at the masterful use of words to describe the pathophysiology, mechanics and solution to a particular problem in simple, understandable language. Translating to lay language is a skill, and an art form all its own. And the most skilled attendings would repeat important elements of the discussion.
Sometimes, as physicians, we can be overworked, over-caffeinated, and just too busy to slow down or repeat ourselves. But using this strategy is making me a better partner, mother, doctor. So, at the risk of repeating myself… give it a try!
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The path can be riddled with failures, even if you're doing it right. In this recording, I share some of my gaffes with you.
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