Most orthopedic surgeons strive to have a positive relationship with their patients by showing compassion for their plight and encouragement for recovery. However, when surgeons experience the surgical process as a patient, a whole new level of understanding and connection is uncovered. Todd Kuether, MD, a spine surgeon, and Ira Weintraub, MD, a joint replacement surgeon, both based at Legacy Good Samaritan Medical Center in Portland, Ore., have been patients for the procedures they now routinely perform on others and they say the experience has influenced their delivery of care.
Both surgeons now have an intimate familiarity with the entire patient process, and they discuss how orthopedists can build a stronger, more trusting relationship with their patients.
1. Sympathize with the patient's pain. Surgeons are familiar with the textbook symptoms for most conditions they treat and are able to assess the appropriate treatment pathway depending on how patients describe their pain. Knowing what to look for is good, but surgeons also need to sympathize with their patients on a more personal level.
"If you can imagine what it's like to have your arm or leg hurting you and you can't sleep, you know what it's like for patients when they reach the point where they just want surgery," says Dr. Kuether. "I got to the point where I wanted surgery and I wanted it right away. For patients, it's difficult to wait for surgery to be scheduled and wait for routine stuff to be finished before they can undergo the procedure. After going through the process myself, I've been able to empathize with my patients."
When he is able to show empathy, Dr. Kuether says patients are more comfortable with him and are able to trust his understanding of their needs as they go through the process.
2. Utilize straight talk. In his practice, Dr. Weintraub has found that patients appreciate his feedback and advice most when he gives it to them straight instead of sugar coating the potential outcomes. Telling the patient, to the best of your knowledge, what to expect for their particular pathology with each treatment pathway can garner respect and trust. If you are having trouble conveying the message clearly, Dr. Weintraub suggests personalizing it.
For instance, if a man with joint problems comes into the office with his wife, she might want to travel during retirement, but he is unable to overcome his joint pain. "This couple is at the point in their lives that they should be able to go if they want to go, so I tell them don't make your knee the reason why you can't," he says. "Every day should be lived as fully as it can be. I make my discussions personal to them because they want to know the physician is hearing them and cares about their situation."
3. Build camaraderie. Digging deeper than the traditional relationship between physicians and patients can promote stronger trust in the physician, says Dr. Kuether. If physicians can relate to the patient more as a partner than a customer or client, patients are set at ease. "I think people really feel comfortable talking about their experience with me because I work with them; I don't think they are crazy to feel the things they feel because I've been through it before and can identify with them," says Dr. Kuether.
Many people undergo surgery after living for a long time with pain and have lost aspects of their quality of life. Dr. Weintraub relates to his patients by recounting how surgery helped improve his quality of life, little by little. "I tell my patients: I met my grandchildren at the park the other day, and my granddaughter loves to slide. I followed her up the slide, carrying my grand son, and then went down. We must have done that 50 times and last year before my surgery I could only do it two or three times."
Like Dr. Kuether, Dr. Weintraub is also able to understand the urgency of patients who have gone through several conservative treatments and are ready for surgery. "Your life is always made up of little things that bring you joy and the feeling of quality in what you do," he says. "I tell everyone that they should get their hip or knee replaced when the quality of life tells them to because they don't know how long they will live."
4. Deliver sound treatment options. There are often several treatment options for patients with joint and back pain, and when it comes to surgery patients want to make sure they undergo the most safe and effective procedure available for them. In the case of spine surgery, many patients are recommended for fusions when they could have just as good of an outcome with a less invasive procedure, says Dr. Kuether, which is what he received and performs for his patients.
"When I am recommending surgery for my patients, I recommend what I would want in that setting," he says. "If someone told me I had to have a fusion, I would have tried to avoid that if possible. I realized that the less invasive option was best for me, and it can be good for many of my patients as well."
However, most surgeons recognize that surgery isn't usually the first treatment pathway they pursue with their patients. As he recommends for his patients, Dr. Kuether also went through six to eight months of conservative treatment and he is able to share what he found worked for him. "Many times patients have questions about acupuncture, physical therapy and cortisone injections, and I tell them about what I did and what worked for me," he says. "We are all different, but this gives them one perspective as they decide what they want to do."
5. Value the patient perspective. It's easy for physicians to tell patients what they can expect throughout the treatment process, but if the physicians haven't been through it they might not have the same perspective. "You have a sense of what they are going through and you can give them a perspective of recovery time and what it takes to get back to recovery levels," Dr. Weintraub says. "It's one thing to say the recovery will take two to six months, but when you have experienced it before you can help your patients know what to expect at different stages of the recovery."
Each patient recovers at their own pace, relating to different benchmarks along the way can be reassuring for patients. During his experience, Dr. Weintraub learned that recovery can sometimes take a lot longer than surgeons expect. "Patients always want to know when they can start doing one activity or another, and surgeons always have a timeline but really they have no idea when the patient will be ready," he says. "I tell patients that it took me a lot longer to get well than I ever thought it would."
He is also able to give patients a realistic perspective of physical therapy: its hard work. "I tell patients physical therapy isn't anything but hard work and they have to tolerate it," he says. "In knee replacement, they won't make it unless they work hard in physical therapy."
6. Reassure patient fears. Patients are often afraid of the pain associated with surgical procedures, which is sometimes fueled by how the surgeons approach the subject. "Some of my patients in the past would fear total knee replacement because I always told them that it's the most painful procedure that we do," Dr. Weintraub says. "But when I went through it, the pain was not nearly what I thought it would be. With the appropriate pain management and experienced surgeon, patients don't nave nearly the pain they fear. Being able to parlay their fears and speak much more understandably about what happens after surgery has been helpful."
Throughout the recovery process, there were little things Dr. Weintraub discovered to help him which he now conveys to his patients. He found certain actions that hurt him and realized several different reactions to the procedure are normal. "Sometimes the knee makes noise, sometimes it feels better one way or another," he says. "For the breadth of symptoms and complaints that people have, it's almost always normal."
7. Relay to patients a good end result. Patients often have anxiety about undergoing a surgical procedure because they're afraid of not returning to their normal level of activity. Surgeons use a variety of methods to ensure patients returning to activity will most likely be the case. One of the best methods of reassurance is through example.
"When it comes to neck and back surgery, one of the biggest questions patients have is: Am I going to be like this forever? Am I going to have a normal life again?" says Dr. Kuether. "I show them I've had neck and back surgery and I play soccer. I work around the house, do manual labor around the house and garden and I can ski. They can see someone who has had it done and gotten back to normal life. That takes some of the anxiety about it away as well."
Dr. Weintraub has had a similar experience with his patients, who sometimes don't believe he has had a knee replacement. He recently saw a patient who was afraid to have her knee replaced because she thought she'd be disabled by the surgery. "When I told her I had my knee done a few months before, she was surprised because it didn't look like there was anything wrong with me," he says. "If you think the surgery is going to last you 20 years and you are already doing better in six months, that's a short time in the scheme of things. I made her more hopeful that she could recover and get back to her life."
If you haven't had surgery yourself, gathering patient testimonial and presenting it through text or video is helpful.
Related Articles on Orthopedic Surgeons:
5 Tips for Optimizing Orthopedic Practice Revenues
Poised for the Future: 6 Ways for Orthopedic Practices Overcome Today's Healthcare Environment
Joint Preservation is the Future of Orthopedic Care
1. Sympathize with the patient's pain. Surgeons are familiar with the textbook symptoms for most conditions they treat and are able to assess the appropriate treatment pathway depending on how patients describe their pain. Knowing what to look for is good, but surgeons also need to sympathize with their patients on a more personal level.
"If you can imagine what it's like to have your arm or leg hurting you and you can't sleep, you know what it's like for patients when they reach the point where they just want surgery," says Dr. Kuether. "I got to the point where I wanted surgery and I wanted it right away. For patients, it's difficult to wait for surgery to be scheduled and wait for routine stuff to be finished before they can undergo the procedure. After going through the process myself, I've been able to empathize with my patients."
When he is able to show empathy, Dr. Kuether says patients are more comfortable with him and are able to trust his understanding of their needs as they go through the process.
2. Utilize straight talk. In his practice, Dr. Weintraub has found that patients appreciate his feedback and advice most when he gives it to them straight instead of sugar coating the potential outcomes. Telling the patient, to the best of your knowledge, what to expect for their particular pathology with each treatment pathway can garner respect and trust. If you are having trouble conveying the message clearly, Dr. Weintraub suggests personalizing it.
For instance, if a man with joint problems comes into the office with his wife, she might want to travel during retirement, but he is unable to overcome his joint pain. "This couple is at the point in their lives that they should be able to go if they want to go, so I tell them don't make your knee the reason why you can't," he says. "Every day should be lived as fully as it can be. I make my discussions personal to them because they want to know the physician is hearing them and cares about their situation."
3. Build camaraderie. Digging deeper than the traditional relationship between physicians and patients can promote stronger trust in the physician, says Dr. Kuether. If physicians can relate to the patient more as a partner than a customer or client, patients are set at ease. "I think people really feel comfortable talking about their experience with me because I work with them; I don't think they are crazy to feel the things they feel because I've been through it before and can identify with them," says Dr. Kuether.
Many people undergo surgery after living for a long time with pain and have lost aspects of their quality of life. Dr. Weintraub relates to his patients by recounting how surgery helped improve his quality of life, little by little. "I tell my patients: I met my grandchildren at the park the other day, and my granddaughter loves to slide. I followed her up the slide, carrying my grand son, and then went down. We must have done that 50 times and last year before my surgery I could only do it two or three times."
Like Dr. Kuether, Dr. Weintraub is also able to understand the urgency of patients who have gone through several conservative treatments and are ready for surgery. "Your life is always made up of little things that bring you joy and the feeling of quality in what you do," he says. "I tell everyone that they should get their hip or knee replaced when the quality of life tells them to because they don't know how long they will live."
4. Deliver sound treatment options. There are often several treatment options for patients with joint and back pain, and when it comes to surgery patients want to make sure they undergo the most safe and effective procedure available for them. In the case of spine surgery, many patients are recommended for fusions when they could have just as good of an outcome with a less invasive procedure, says Dr. Kuether, which is what he received and performs for his patients.
"When I am recommending surgery for my patients, I recommend what I would want in that setting," he says. "If someone told me I had to have a fusion, I would have tried to avoid that if possible. I realized that the less invasive option was best for me, and it can be good for many of my patients as well."
However, most surgeons recognize that surgery isn't usually the first treatment pathway they pursue with their patients. As he recommends for his patients, Dr. Kuether also went through six to eight months of conservative treatment and he is able to share what he found worked for him. "Many times patients have questions about acupuncture, physical therapy and cortisone injections, and I tell them about what I did and what worked for me," he says. "We are all different, but this gives them one perspective as they decide what they want to do."
5. Value the patient perspective. It's easy for physicians to tell patients what they can expect throughout the treatment process, but if the physicians haven't been through it they might not have the same perspective. "You have a sense of what they are going through and you can give them a perspective of recovery time and what it takes to get back to recovery levels," Dr. Weintraub says. "It's one thing to say the recovery will take two to six months, but when you have experienced it before you can help your patients know what to expect at different stages of the recovery."
Each patient recovers at their own pace, relating to different benchmarks along the way can be reassuring for patients. During his experience, Dr. Weintraub learned that recovery can sometimes take a lot longer than surgeons expect. "Patients always want to know when they can start doing one activity or another, and surgeons always have a timeline but really they have no idea when the patient will be ready," he says. "I tell patients that it took me a lot longer to get well than I ever thought it would."
He is also able to give patients a realistic perspective of physical therapy: its hard work. "I tell patients physical therapy isn't anything but hard work and they have to tolerate it," he says. "In knee replacement, they won't make it unless they work hard in physical therapy."
6. Reassure patient fears. Patients are often afraid of the pain associated with surgical procedures, which is sometimes fueled by how the surgeons approach the subject. "Some of my patients in the past would fear total knee replacement because I always told them that it's the most painful procedure that we do," Dr. Weintraub says. "But when I went through it, the pain was not nearly what I thought it would be. With the appropriate pain management and experienced surgeon, patients don't nave nearly the pain they fear. Being able to parlay their fears and speak much more understandably about what happens after surgery has been helpful."
Throughout the recovery process, there were little things Dr. Weintraub discovered to help him which he now conveys to his patients. He found certain actions that hurt him and realized several different reactions to the procedure are normal. "Sometimes the knee makes noise, sometimes it feels better one way or another," he says. "For the breadth of symptoms and complaints that people have, it's almost always normal."
7. Relay to patients a good end result. Patients often have anxiety about undergoing a surgical procedure because they're afraid of not returning to their normal level of activity. Surgeons use a variety of methods to ensure patients returning to activity will most likely be the case. One of the best methods of reassurance is through example.
"When it comes to neck and back surgery, one of the biggest questions patients have is: Am I going to be like this forever? Am I going to have a normal life again?" says Dr. Kuether. "I show them I've had neck and back surgery and I play soccer. I work around the house, do manual labor around the house and garden and I can ski. They can see someone who has had it done and gotten back to normal life. That takes some of the anxiety about it away as well."
Dr. Weintraub has had a similar experience with his patients, who sometimes don't believe he has had a knee replacement. He recently saw a patient who was afraid to have her knee replaced because she thought she'd be disabled by the surgery. "When I told her I had my knee done a few months before, she was surprised because it didn't look like there was anything wrong with me," he says. "If you think the surgery is going to last you 20 years and you are already doing better in six months, that's a short time in the scheme of things. I made her more hopeful that she could recover and get back to her life."
If you haven't had surgery yourself, gathering patient testimonial and presenting it through text or video is helpful.
Related Articles on Orthopedic Surgeons:
5 Tips for Optimizing Orthopedic Practice Revenues
Poised for the Future: 6 Ways for Orthopedic Practices Overcome Today's Healthcare Environment
Joint Preservation is the Future of Orthopedic Care