What Patients Say, What Doctors Hear

by Danielle Ofri MD

Overview

Can refocusing conversations between doctors and their patients lead to better health?

Despite modern medicine’s infatuation with high-tech gadgetry, the single most powerful diagnostic tool is the doctor-patient conversation, which can uncover the lion’s share of illnesses. However, what patients say and what doctors hear are often two vastly different things.

Patients, anxious to convey their symptoms, feel an urgency to “make their case” to their doctors. Doctors, under pressure to be efficient, multitask while patients speak and often miss the key elements. Add in stereotypes, unconscious bias, conflicting agendas, and fear of lawsuits and the risk of misdiagnosis and medical errors multiplies dangerously.

Though the gulf between what patients say and what doctors hear is often wide, Dr. Danielle Ofri proves that it doesn’t have to be. Through the powerfully resonant human stories that Dr. Ofri’s writing is renowned for, she explores the high-stakes world of doctor-patient communication that we all must navigate. Reporting on the latest research studies and interviewing scholars, doctors, and patients, Dr. Ofri reveals how better communication can lead to better health for all of us.

Product Details

ISBN-13:	9780807087497
Publisher:	Beacon Press
Publication date:	02/06/2018
Pages:	248
Sales rank:	312,608
Product dimensions:	5.40(w) x 8.40(h) x 0.40(d)

About the Author

Danielle Ofri, MD, PhD, is an associate professor of medicine at the New York University School of Medicine and has cared for patients at New York’s Bellevue Hospital for more than two decades. She is the author of, most recently, What Doctors Feel: How Emotions Affect the Practice of Medicine, as well as the critically acclaimed Singular Intimacies, Incidental Findings, Medicine in Translation, and the e-book original volume Intensive Care. Writing in the Guardian in the spring of 2016, Andrew Solomon singled out Ofri as the only woman among an extraordinary new generation of doctor writers, saying, “Ofri has produced four impressive books and numerous articles, all striking for their reversion to empathy, their willingness to sense not only the physical life of a patient, but also the emotional.” She lives in New York City.

Table of Contents

Chapter 1 Communication and Its Discontents 1

Chapter 2 From Both Sides Now 8

Chapter 3 It Takes Two 22

Chapter 4 Now Hear This 36

Chapter 5 With All Good Intentions 48

Chapter 6 What Works 69

Chapter 7 Chief Listening Officer 91

Chapter 8 Listen to Me 101

Chapter 9 Just the Facts, Ma'am 120

Chapter 10 Do No Harm 132

Chapter 11 What Lies Beneath 152

Chapter 12 The Language of Medicine 166

Chapter 13 Rushing to Judgment 179

Chapter 14 Can It Be Taught? 194

Chapter 15 A Fragile Truce Shatters 207

Chapter 16 Can We Talk? 217

Acknowledgments 228

Notes 230

Index 236

Editorial Reviews

Her revealing doctor-patient stories often make her seem like the doctor that every patient wishes they had, and she draws on patient accounts to illustrate the problems that can arise in communication between doctor and patient. This book, however, goes far beyond Ofri’s personal experiences with patients. She delves into the relevant research on communication, citing some ingenious experiments on listening...A much-needed, convincing argument that, regarding doctor-patient communication, the stakes are very high and that what patients say is all too often not what doctors hear—and vice versa.”
—Library Journal

“This book has convinced me that the communication skills, which reveal a physician’s compassion, empathy, and respect, will also have a significant effect on the health outcomes of patients.”
—Eyenet Magazine

“With disarming candor and penetrating insight, Dr. Ofri illuminates the enormous power of what might seem at first a mundane and insignificant element in the practice of medicine: communication.”
—Deborah Tannen, professor of linguistics at Georgetown University and author of You Just Don’t Understand and You’re Wearing THAT?

“With the meticulous care of Oliver Sacks and the deep humanism of Atul Gawande, Danielle Ofri has written a book about the role of communication in medicine. She presents compelling evidence that even as doctoring appears to be dominated by technology, the human, affective relationship is at the very center of responsible practice.”
—Andrew Solomon, author of Far from the Tree

Praise for Danielle Ofri

“Taut, vivid prose...She writes for a lay audience with a practiced hand.”
—Katie Hafner, New York Times

“A gifted storyteller.”
—Sarah Halzack, Washington Post

“The world of patient and doctor exists in a special sacred space. Danielle Ofri brings us into that place where science and the soul meet. Her vivid and moving prose enriches the mind and turns the heart.”
—Jerome Groopman, author of How Doctors Think

“I highly recommend [Danielle Ofri’s work] for physicians, would-be doctors, and anyone interested in medicine in all its behind-the-scenes glory.”
—Sandeep Jauhar, author of Intern: A Doctor’s Initiation

“Danielle Ofri’s sensitivity to every aspect of her patients’ lives is immensely impressive and moving. If only more doctors could be (and write) like this!”
—Oliver Sacks, author of Awakenings

“[Ofri’s writing] about the emotional life of doctors and their patients, captivated me so much...Read[s] like a deftly crafted and luminously written novel.”
—Caroline Leavitt, Boston Globe

From the Publisher

02/01/2017
The most important factor in getting good health care is communication between doctor and patient. Ofri (medicine, New York Univ.) has been practicing at New York City's Bellevue Hospital for more than 20 years. She uses case histories from her own experience as well as those contributed by colleagues to illustrate what can go wrong when communication fails. She also shows what works and discusses research into doctor-patient communication. Given the time crunch that doctors face and that patients feel intimidated and rushed during their appointments, the potential for frustration, medical error, and poor relationships is high. Ofri says that this does not have to be the case. By identifying the barriers that prevent effective communication and taking steps to remove them when possible, both doctor-patient interactions and clinical outcomes will improve. Ofri's honest, open comments about her own failures and successes will educate physicians and patients. VERDICT Anyone interested in health care will learn a great deal from reading this book.—Barbara Bibel, formerly Oakland P.L.

Library Journal

2016-11-09
Why communication between doctor and patient is the most critical element of medical care.Ofri (New York Univ. School of Medicine) is not only a practicing clinician, but an author (What Doctors Feel: How Emotions Affect the Practice of Medicine, 2013, etc.) and editor-in-chief of the Bellevue Literary Review. Her revealing doctor-patient stories often make her seem like the doctor that every patient wishes they had, and she draws on patient accounts to illustrate the problems that can arise in communication between doctor and patient. This book, however, goes far beyond Ofri's personal experiences with patients. She delves into the relevant research on communication, citing some ingenious experiments on listening. Studies show that the better the listener, the better the speaker, and listening is one of the hardest skills that a doctor has to master. But it can be taught, and Ofri reports that medical schools across the country are developing formal curricula to that end. However, patients, the author asserts, are the best teachers in that department, and the many stories she includes about her own struggles to communicate bear this out. In one case, she spent many visits with a patient who could not cope with multiple pills for a host of chronic conditions before discovering that all her carefully written schedules telling him when to take what were totally useless: he revealed to her that he had never learned to read. Although Ofri focuses on what doctors can do to be better communicators—e.g., focus on the patient and shut up "at least a little bit"—she offers advice to patients as well (insist on adequate time to tell your story, and prioritize what you want to talk about).A much-needed, convincing argument that, regarding doctor-patient communication, the stakes are very high and that what patients say is all too often not what doctors hear—and vice versa.

Kirkus Reviews