The first time I worked with a physician was during my training as a suicide risk assessment consultant in a hospital.
My job was simple: give the nice doctor a brief run-through of the patient presentation and make recommendations for treatment. I walked into the doctor’s office, smiled, took a deep breath, and I began to regale them with the tale of my time with the patient and how they made me feel.
After about thirty seconds, my story was cut short.
The doctor shook his head, raised his hand, and said “you’re burning my time buddy, just tell me what I need to do.” Caught off guard and sweating profusely, I managed to stumble through some recommendations before the physician said “sounds great” and turned back to his notes.
Therapists (tend to) have excellent communication skills. We really shine in environments where we can take time to build trust and speak openly, but the time crunch of the medical system tends to limit that space.
So, how do we adapt to working within a system that is all about efficiency and pragmatism?
Here are five tips that will help you talk to the doc:
1. Proceed with Humility
Humility is particularly important for those of us who are students, interns, or early career professionals. Granted, this isn’t just about being new or inexperienced. From a systemic perspective, mental health has only recently made its way into the medical arena. We are the new kids in town, and sometimes that can feel threatening. Your ability to demonstrate humility will open the door to stronger rapport with your teammates.
How do you show humility in the workplace?
This demonstrates interest in the person and their work while also giving you a chance to learn.
Say “Thank You”
Humility walks hand in hand with gratitude. Thank your teammates for the work they do, especially when that work generates a client referral.
Eat Lunch With the Crew
Many of us use lunch breaks as a time to get centered and recharge, but this usually means alone time. Try hanging out in the lunch hall / employee lounge; those physicians are a lot less intimidating when they are eating PB&J. This will show the team you aren’t above spending leisure time with them, and it can help you form relationships outside of client work.
Use some of those active listening skills.
You can pick up how physicians and other medical staff want you to communicate with them by observing them in their natural environment. If you are just starting a new position in behavioral health, try shadowing members of the medical team.
Listen for how they communicate with their patients and other team members. Some physicians use humor, others prefer to cut to the chase. As you learn how the team operates, you can begin to piece together their expectations for behavioral health.
You are a cog in the medical machine, and you don’t want to miss your turn.
3. Conduct an Um-ectomy
Clear communication is essential in the medical world. One way to dramatically improve your clarity is to practice speaking without the use of language fillers, such as “um” and “ah”. It’s um a lot ah harder to um keep up with the uh message when um you speak like this.
Toastmasters, a public speaking organization, trains people using a bell that is rung each time the speaker uses a language filler, such as um. Think of your ums as being as loud and intrusive as a clanging bell.
Language fillers can be a difficult habit to break, so be kind to yourself as you continue to clarify your speech.
4. Deliver with DRSMAP
Feeling lost? Just use DRSMAP (pronounced Doctor’s Map).
Sometimes our thoughts can get scattered during the rapid pace of medical work. DRSMAP is a basic formula used by health professionals to organize and communicate a brief case presentation.
DRSMAP is an acronym for Demographics, Reason for Referral, Symptoms, Motivation, Assessment, and Plan. It’s easy to learn and easy to use, with practice. Here’s the breakdown:
Who is the patient? This part includes whatever might be relevant to the case, but I tend to say the patient’s name, age, ethnicity, employment status, and gender identification. For example, “the patient is a 40-year-old, Latino, employed male.”
Reason for Referral
Why is the patient here today? This part provides orientation for what we need to do to help, and what might be the precipitating event. For example, “the patient might be in the emergency department after an overdose.”
What is the patient presenting with? Be ready to provide a quick list of symptoms and their duration. Use of numbers can also be effective, such a PHQ-9 score. For example, “the patient, who scored a 20 on the PHQ-9, is suffering from depressed mood, loss of interest, difficulty sleeping, isolation, weight gain, and suicidal ideation for the past 10 months following a divorce.
What does the patient want right now? The answer to this question can be as diverse as the patients we serve. This information can make a substantial difference in patient satisfaction and treatment adherence. You can also mention whether or not the patient is motivated for treatment.
How did you diagnose them? Give a specific diagnostic impression and clarify if needed. For example, “I diagnosed him with Major Depressive Disorder based on the severity of symptoms and the time frame.”
Where do we go from here? Now you provide your recommendations based on who the patient is, why they came in, and what they are dealing with. This part can vary significantly based on your setting, but this could be as simple as “the patient has agreed to a safety plan and is ready to initiate counseling services.”
5. Extract Some Feedback
Ask for feedback from your teammates about your work and how you can improve. The pace of a medical clinic doesn’t tend to leave room for process questions. Start by asking your teammates if you can connect with them for feedback on occasion. I like to use the question, “What did I do well, and what do you wish I could have done better?”
Use a growth mindset, and don’t be bogged down by negative criticism. You are a developing clinician, and your desire to improve will be your greatest strength.
Do you have other tips for communicating well with a medical team? Share them with the Time2Track Community below!
Editor’s Note: This article was originally published in September 2017 and has been updated for accuracy and comprehensiveness.
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