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Coaching for More Effective Communication
with Your Doctor

Pat Kufeldt
Burke, Virginia, USA
From: LEAVEN, Vol. 36 No. 5, October-November 2000, pp. 92-93

This is the conclusion of a three part series about coaching for better communication. There are times when a Leader can offer the encouragement of coaching support in addition to information. Part 1, "Coaching for Effective Communication" appeared in the June-July, 2000 issue of Leaven and Part II, "Coaching for Effective Problem Solving" appeared in the August-September issue.

Some people find communicating with doctors to be intimidating. This is especially true if there is a difference of opinion or a desire to challenge the physician's advice in some way. In this situation, a Leader can be very helpful. Not only can she provide information to the mother, but she can provide some tools to make the experience less threatening and more successful. Once the Leader has imparted all the information available on a subject, she can further help a mother prepare by suggesting role-play. Situations that may lend themselves to this kind of assistance include those where it appears that:

  • the information may be new to the doctor.
  • there are alternative actions that can be considered.
  • a mother has not dialogued with the doctor.
  • a second opinion might be valuable.
  • the doctor's personal opinion, rather than medical fact, might be a motivating factor in his recommendation.

Use This Pattern to Dialogue

Present the problem: When (describe the problem), I feel (describe the feeling) because (give the reason), Example: When you say that I need to have surgery next week, I feel apprehensive because I'm afraid that I'll have to give up breastfeeding, which is very important to me.

Listen to the doctor. First respond by demonstrating that you were listening: As you see it, it is vital that I have this surgery now and though it may interrupt breastfeeding, you feel certain that it is for the best.

Second, respond with a question: Is there any possibility that the surgery could wait six weeks?

Share information: l have been doing some research on the subject and I read that...

Make a request: Could you tell me more about... ?

Set a limit: I'm not willing to wean my baby right now.

Recycle the process three to five times as needed.

The dialogue that follows concerns a mother whose doctor has recommended a surgical treatment that will interfere with breastfeeding in some way. The Leader has given this mother a great deal of information. The Leader is worried that the mother will either use the information without consulting her doctor or give up nursing her baby.

Leader: Danni, I've given you a lot of information here. You may have questions for your doctor.

Danni: Well, I do have questions, but I'm not sure I could talk to the doctor.

Leader: You are uncomfortable about talking to the doctor because you're not sure how he will respond.

Danni: Yes. He always seems so sure of himself and it seems to me that he believes there is only one way to do things. Maybe I'll just ignore what he says and go with this information.

Leader: You feel shaky about the idea of questioning your doctor and yet it's important to you to continue nursing your baby. While I can understand how you feel, I'm wondering at the wisdom of not trying to talk to him. It seems to me that he's going to find out sooner or later.

Danni: You're right. I just don't know what to do.

Leader: I'd be glad to help you rehearse what you want to say. I could play the role of the doctor and you would be you. How does that sound?

Danni: Maybe it would help me to get up my nerve. Okay, what do I do first?

Leader: There are several ways that you could lead into the conversation. You could say:

  • "Doctor, I have a concern."
  • "I've been thinking about what we discussed and... "
  • "I'm wondering if you've (heard about, read about, know about?)"
  • "I don't know if I've told you how much breastfeeding means to me." That's another way to begin the discussion.

Danni: When I think about it, I'm not sure he knows how I feel. I could say, "Doctor, I think breastfeeding is important to my baby and I'm not ready to give it up yet."

Leader: That sounds fine. In addition, you can make it stronger by telling him how you're feeling about the idea of this surgery.

Danni: How about, "When you say that I need to have surgery next week, I feel upset because I'm afraid that I'll have to give up breastfeeding, which is very important to me."

Leader: Danni, that comes across very clearly. The next step is to really listen to his response. I'II be the doctor, "Well Mrs. Smith, you know you'll be absolutely no good to anyone in the family if this condition continues."

Danni: At this point I'd probably start crying! I'm not good at this stuff.

Leader:It's distressing to think about challenging the doctor in any way. You're afraid you won't be able to do it. Take a minute and think about what he said. How do you think he feels? Is be angry, worried, or impatient? Take a deep breath.

Danni: Okay. Doctor, you are worried that if I don't have this surgery, I won't be able to take care of the baby. In your view it would be foolish to put off the surgery, even if it means weaning my baby.

Leader: Terrific! You listened to what the doctor was saying. Now is the time to ask a question or give more information. Remember, we talked about the option of delaying this surgery? This would be the time to mention again how important breastfeeding is to you and to ask about that possibility.

Danni: Breastfeeding is very important to my baby and me and I'm reluctant to do anything to disturb that relationship. I'm wondering how it would affect me if I delayed having the surgery?

Leader: At this point you need to listen closely to the doctor again and perhaps recycle some of the things you've already said. I can't promise you that this will be easy, but it will certainly increase your knowledge and feeling of self-worth.

Here are some additional phrases that may be helpful as you dialogue.

  • Doctor, what I hear you saying is...
  • In light of this new information...
  • I appreciate your concern.
  • We both want what is best for mother and baby

These phrases are useful for asking questions:

  • Is it possible that this (treatment, surgery) could wait?
  • Would you consider... ?
  • Is there some way we could...?
  • Can you tell me more about... ?
  • What will the consequences be if I (delay this treatment, consider alternatives, do nothing?)
  • What effect will there be on the baby if I continue to breastfeed and (take this treatment, do nothing?)
  • What medication would you recommend if the baby had this condition?
  • What medication would you have recommended 10 years ago?
  • What medication would you recommend if circumstances prevented me from taking this one?

Keep in mind that as you are pursuing your goal to continue breastfeeding you need to continue listening to the doctor's answers and demonstrating your understanding by saying:

  • So, what you are saying is...
  • As you see it...
  • From your point of view...
  • In your eyes...
  • Your information leads you to believe...
  • What you are telling me is...

Leader: Danni, good luck with your dialogue. I know how important this is to you and I'd love to hear how it goes. Listen to the doctor, and don't forget to breathe!

Coaching is an important tool for Leaders. Some people need more than information. They need an opportunity to practice new ways of talking to the important people in their lives.

This article is the conclusion of a theme on coaching for better communication from the last issue of Leaven. The other articles in this series:

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