The Power of “Thank You”

Premier Pulse     March 2018

By Marc Belcastro, DO, chief medical officer, Premier Health Southern Region

As chief medical officer of Premier Health’s southern region (Miami Valley Hospital/Miami Valley Hospital South/Atrium Medical Center), I am thankful for the opportunity to serve you. I hope this series on patient experience has engaged your heart as much as your mind. Thank you for your time as you read these thoughts.

While this article addresses the measures called HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems), my true intent is to draw you back to our calling as physicians and hope that you find the personal fulfillment that I did. For your information only, I have included the questions patients are asked when evaluating their physician communication. Truly, scores aside, would you not want your patients to answer “always” to these questions?

  1. During this hospital stay, how often did doctors treat you with courtesy and respect?
  2. During this hospital stay, how often did doctors listen carefully to you?
  3. During this hospital stay, how often did doctors explain things in a way you could understand?

This series has been intended to challenge you to slow down and consider the importance of your words and body language during patient interactions. AIDET (acknowledge, introduction, duration, explanation, and thank you) is not a script. Rather, it is simply a disciplined reminder of the skills/behaviors that leave our patients feeling cared for and respected; decrease their anxiety; and have been scientifically shown to improve their clinical outcomes.*

This article addresses the “thank you” component of AIDET, but I first would like to revisit the most important discipline we can practice: the silent discipline of sitting. Finding a way to sit down, level the eye contact, and pause a moment will be a game changer. More than 50 percent of what people sense from us when we communicate with them is the result of our body language. Many times, during my career, when an infant was critically ill or even on the verge of death, I would come to the room and ask the family if I could sit with them. No words needed to be exchanged. If I did speak, it would be as I was leaving. I would simply say, “thank you for allowing me to sit with you.”

That brings us to the “thank you” that should be the punctuation at the end of each patient encounter. Understandably, if this is not part of your routine, it can feel a bit awkward or strange. However, in just a short amount of time, you will recognize the sheer power of this expression, and it will flow naturally. There is a true humility that is felt when someone says thank you. Some patients with naturally grateful hearts will feel like they should be the one saying thank you, and they undoubtedly might. Even more rewarding, though, is the impact an expression of gratitude can have on a patient who might be angry or resistant to our care. This impact might not be seen or felt in the moment, but the lowering of defenses that takes place when sharing a “thank you” during a challenging encounter almost always leads to a “turning” of the patient/physician relationship, especially if it has been strained.

Finally, as you thank your patients throughout the day, you may notice a subtle shift in yourself. The work will remain, the stress will continue, and the frustrations will come. However, your energy, your strength, and your ability to adapt will all be renewed by the resilience of a gracious heart.

* Examining the Role of Patient Experience Surveys in Measuring Health Care Quality   

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