A Picture is worth a thousand words...

Getting ideas across to other people isn't always easy, and with patients this can be quite challenging. Analogies can be helpful but sometimes we are left with a feeling that we have failed to get our message understood. Explanatory material may have assisted, but you did not have this at hand!

The familiar expression... 'A picture is worth a thousand words'... refers to the notion that complex ideas and concepts can be conveyed more easily with an image, or that an image of something conveys its meaning better than any description alone can achieve

All professionals know this. Few of us would consider giving a presentation to a non-expert audience on a complex topic without the aid of explanatory pictures, videos, diagrams or graphs.  

So why don't doctors use these resources more often with their patients?

Effective communication is vital throughout the patient 'journey'. This exchange of information (a two-way process) is especially important early in the consultation process to build up rapport, and because this is when key management decisions are likely to be made. Yet, within the time constraints of a typical office consultation it can be challenging to get all the information needed from the patient, and to give patients all the information they need to make informed decisions.

Patients come to doctors for help and advice because they have a medical problem that negatively impacts on their quality-of-life, general well-being or their ability to perform day-to-day activities. To help patients, doctors need to formulate a diagnosis. This is so they can:

  • Tell them what is 'wrong' and explain the nature of their condition

  • Formulate reasonable treatment options to discuss

  • Explain the effectiveness, limitations and risks of the options discussed, and select the one that best suits the patient's needs

 

Medical concepts

Getting to the bottom of any patient's problem (the 'diagnosis') is essentially a fact-finding exercise. The 'data' the doctor needs comes from the clinical presentation, the examination and special tests.

With experience this process becomes second nature to doctors. All aspects of the condition they need to explain to their patients (from cause, pathology etc... to outcome and prognosis) are at the forefront of their minds. However, these are complicated matters. What can be difficult for the specialist is making sure that they have effectively conveyed this complex information to patients.

Patients often have particular difficulty in understanding anatomy and the nature of surgical interventions just from a verbal description. This is hardly surprising!

Yet, doctors know that they must get this information across in a way that patients can understand. This information exchange also forms an essential part of the consent process before any intervention takes place (GMC).

 

Conveying information

Doctors have traditionally used x-rays, skeletons and leaflets when explaining clinical concepts. Nowadays doctors have a laptop or PC monitor on their desk, or a tablet or smartphone in their bag.  So a better and more modern way to educate patients is to use online resources; e.g., a simple Internet search for images or videos (after typing in the diagnosis or procedure/intervention). Once located, these images/videos can then be used to get important points across. 

I have been routinely using this in my practice for a decade or so and found it enormously helpful and effective. Patients are grateful to me for taking the extra time involved. It also gives patients confidence in you as a professional and gives them a good experience right from the outset!

Concepts that can be explained more fully using the Internet include: anatomy and microanatomy; pathomechanics; pathophysiology; and the nature of proposed interventions or potential risks.

 

How better to explain to a patient what a particular hand condition is, how it develops, how you propose to treat it, and what structures in the hand and fingers are at risk from injury?

Helpful tips for colleagues!

  • You'll be doing this right in front of the patient, so it may take some practice until you become comfortable, and it becomes routine for you

  • If using a fixed monitor, and patients cannot see the screen easily from the other side of the desk or office, get up and invite the patient to sit in your chair so they can get close to the screen

  • Be wary of showing gory images of extensive surgical operations or nasty injuries – some patients don't like that (so check with them first)

  • Write down the diagnosis/intervention etc. together with suggestions for helpful websites on your business card and give it to the patient with an explanatory leaflet on their condition; they can then do some 'homework' before they see you next

  • Videos take up more of the consultation time than simple images, so it's normally better to direct the patient to the relevant site for review after the consultation

  • Make a note in your clinic annotation that you have enhanced the consultation/consent process by using explanatory images or videos (for medicolegal reasons… It is a sign that you have been thorough)

 

While many doctors do adopt a similar approach to this with their patients, I have observed that many do not. This is surely a missed opportunity for the doctor, and his patient!

As a clinician, I have found using the Internet in this way extremely rewarding.

I hope you do to!