During this pandemic several family physicians have retired, leaving many patients without a primary care provider. As I have been chipping away at my wait list, I am reminded that patients want to be understood as much as they want a diagnosis.
At one level, in my context, a large portion of my patients speak primarily Vietnamese. Their fear is that they cannot express themselves sufficiently in English, so they want someone who can understand their native tongue and help them navigate the medical system.
Yet in a broader sense, patients also want to have someone who can understand the full scope of their situation - the distress that the disease has caused on their daily activities. Lacking that attention, their anxiety can (to borrow phrasing from "Difficult Conversations" by Stone, Patton, and Heen) "wander around the conversation looking for some acknowledgement to hook onto".
So rather than being too quick to blurt out a diagnosis and plan, I try to give ample time for patients to say what they need to say. After all, it's paid off for me time and again - patients tend to be really generous when I'm honest that I don't know what's causing their disease and need more time to figure it out. That extra time tends to give a good resolution to their illness experience.
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