Written by Nick Papastamatis - Practice Leader
It’s a journey of discovery for the patient
“You are not your MRI…”
This sentiment is thrown around A LOT by people in the industry.
My experiential contrast is..
“I have never regretted sending someone for an MRI”
Patient’s are often driven by the fact that they now know what’s wrong so they can move through it.
In any case.. Patients take away meaning from their diagnosis and what is written on the report - even what the scan looks like..
So how does one handle a conversation around scans and what they mean?
Well, here is how I’ve handled it over the past 10 years.
The outcome of the conversation is moderated by two very important factors:
The type of conversation you have about the MRI
The attitude shown towards the MRI
Let me explain…
If you’re in healthcare looking after patients, we have all had someone come in with a pile of scans and they say..
“Right.. So I’ve brought everything with me, and I’m hoping you can help me with this problem that no one seems to have any idea how to solve…”
If you’re a patient reading this.. Ask yourself… what would you want the practitioner to do with those scans?
If you’re a practitioner reading this.. Ask yourself… what have you/would you do in this situation?
I can tell you what I’ve done:
Gone through each one individually
Pushed the scans aside and carried on asking questions
Looked at the scans whilst they’re talking to me
Take a closer look after the consult when they’re not in the room
Don’t look at them at all
Tell them that the scans often don’t reflect the problem
Be pinpoint about the diagnosis
Point out specific things on the scan
More more more
I’ve tried many different approaches - and of course I can’t tell you which one is the best.
REGARDLESS..
The moment a patient brings you a scan (practitioners need to keep in mind)…
The patient THINKS that it’s important.
The patient is walking in with a pre-conceived idea.
The patient has gone to the effort to get it done, remember them, they are hoping you can help them build better meaning!
If patients knew what it all meant, then they’d just tell you what is wrong and leave the scans at home - but they don’t. They bring them, they are looking for someone to help them make sense of what is going on.
So let’s go back to the 2 very important moderating factors:
The type of conversation you have about the MRI
The most important thing: Start by identifying what their narrative is about what their scans mean to them. This enables you as a practitioner and an expert guide, to understand the layers that need to be ‘de-educated’. (‘De-educated’ refers to the reversal of thoughts and beliefs that aren’t helpful)
Acknowledge why you’ve brought the scans in
Recognise that this has taken time and effort (without result)
A series of questions regarding whether the scan and what it says is relevant or not
A detective-like explanation of the deduction or conclusion that your discussion might suggest
An opportunity for the patient to ask questions and concerns about the scans and what they mean.
Proposed next steps, including an assessment and a plan of action to solve the problem as discussed.
The issue I’ve seen, and the issue I believe at large - is that practitioners are too quick to draw conclusions before considering that the patient is actually a PERSON, who has needs that require YOUR attention.
The attitude shown towards the MRI
How you handle the envelope. Behaviours such as:
Carefully take them out?
Throw them on the treatment table?
Keep them in order?
Put them up against a light box?
Nonchalantly hold them against the ceiling light or window?
If a large majority of communication is non-verbal.. Then really, it’s what you don’t say that means the most.
Both of these moderating factors I personally take into account and can honestly say that there is no correct way of going through it… My approach will vary depending on the person in front of me and how important they believe the scans are…
The bottom line is - our approach allows us to deliver the message the patient NEEDS to set them up for success.
Written by Nick Papastamatis - Practice Leader