WORKOMICS (WKO): How do you go about explaining complex information to your patients?

Dr. Heather Senn: That’s always a challenge and something I’m constantly working to improve on. I develop scripts that I work from, not like a written script, but just a script in my mind for common things that come up. I come up with ways to describe it and refine them over time. Some of those things I get pretty good at, like describing the problems to do with high blood pressure, high cholesterol—things that come up fairly frequently.

I also often rely on photos and diagrams. I find even just having access to Google Images very helpful, so I can quickly pull up a diagram of a heart, for example.

Sometimes I use analogies, but I try not to too frequently because sometimes that confuses people and I find it’s easier to explain the actual concept in simplified terms.

And I try to use as little jargon as possible, or if I am going to rely on medical jargon, then I’m careful to define it and make sure that the patient knows exactly what I’m talking about.

WKO: How do you know if a patient has understood what you explained to them?

HS: You can kind of get a sense if they’re nodding along with you or repeating back to you things, or making realizations as they go. “Oh, I see. So that means, if a, b, and then c…

Something we’re taught in medical school is to have patients repeat back to you what they’ve understood. You say, “Okay, so I just gave you a lot of complex information. Why don’t you repeat back to me what you’ve understood so that I can fill in any gaps and clarify anything that is still unclear to you?” That usually helps because they’ll start explaining it and then you can realize where things are missing.

WKO: Are there any interesting tools that you use to explain complex concepts to patients?

HS: The most common one that I’m thinking of is a score for cardiovascular risk. There’s a company that has made an infographic version of a very complex calculation tool. You can put in all the patient’s demographics and their cholesterol levels in this infographic and it pops up a visual representation of what their risk is. Then you can modify certain factors to show how it changes their risk. I find things like that are really helpful in helping people visualize things.

WKO: How do you counter misinformation without alienating a patient?

HS: That can be hard, especially in the age of computers and the internet. People are constantly looking up their symptoms and often come in with a laundry list of what they think is going on. I find it can be helpful to start from that perspective. I try to get an idea if the patient has some perception of what they think is causing their symptoms or their problems. Or if they have some idea about how things should go or what treatment or investigations they need based on what they may have already read.

I find the best thing to do is validate the patient’s ideas and the patient’s research that they’ve spent the time on. Not validate that it’s true, but validate that that’s a normal thing to do. Proceed to highlight what it is they’ve learned that’s correct, then go and correct anything that is incorrect by explaining to them why. Often there’s a piece of information they’re lacking or an assumption they’ve made that’s not correct, and if I correct that little thing and tell them the correct information, then usually that goes over pretty well.