Communication and Connection by Mireya Avila

Communication is a foundational tenant of health care. It frames every interaction a patient has – from the reception desk to the exam room. It affects care in every way possible. So how does one speak with a patient to influence their behavior without just becoming another person ordering them about?

At my service site, Maria de los Santos, I work alongside medical assistants and practitioners to ensure patients are up to date on their preventative screenings (mammograms, colonoscopies, pap smears). I’ve learned that I cannot simply tell patients they’re due for a preventative screening and send them on their way. It’s not realistic to expect that they’ll walk away from that interaction understanding what I’m asking them to do and why. Most of the patients I see come to their primary care doctor about a specific health issue. I am not their practitioner, and I’m talking to them about something that’s not even on their health radar (usually). From the start of my NHC term, I’ve been working on how to best integrate myself in the patient’s experience without being seen as adding chores to their health care. Communication has become my best tool in connecting with patients and helping them decide how to best improve their health.

The CDC reports that most Americans underuse preventative services and individuals experiencing socioeconomic disadvantages are even less likely. I’m based at a federally qualified health clinic where the patient population has a high occurrence of barriers to health care. I quickly learned after I first arrived at my site that talking about percentages and higher-risk populations for cancer was not going to motivate patients to follow through with their preventative services. It became evident that even referrals from the doctor weren’t enough sometimes. I could see in patient’s charts unused mammogram and colonoscopy referrals going back years.

I’ve learned that language is very important when trying to influence better health behaviors. Asking patients if they will tell me about their last mammogram or what they know about pap smears rather than just informing them it’s time for a repeat. Instead of asking “why don’t you”, asking patients “what happened”. When patients can talk about their lives and health that happen outside of the clinic, they seem to be more receptive to any recommendations I make. For example, if a patient has a lot going on at the moment, we discuss postponing a screening or maybe touching base next week to come pick up an at-home test.

It’s my responsibility to ensure patients have the opportunity to access preventative medicine and to make it an overall positive experience that is worth their time so they might continue to seek preventative measures Communication breeds connection. The understanding and trust that come with that help patients achieve their best health.