Behind Worry Lines: Anticipating Patient Concerns

“If I’m scheduled for a colonoscopy, but i have a hemorrhoid should I still get it done or will it hurt during the procedure.?”
“If I get a hip replacement will I be able to have sex again without pain?”
“What happens to the space where my uterus was?”

After reading a brief description of what happens after a hysterectomy, and how the other organs in the body shift to fill the space where the uterus was, the woman was thrilled.

“No one explained that to me. And it’s really been bothering me. This puts my mind at ease.”

Even though people are encouraged to prepare questions before they go to see healthcare providers, people know they have limited time. And they often worry their questions about how a scar will look after it heals may come off as vain. Or they’re embarrassed to ask about topics like bowel movements, hemorrhoids, or sex.

Sometimes knowing is simply reassuring and helps people make sense of the situation. Other times, knowing the answers to something like whether hemorrhoids will make a colonoscopy more painful or not can help reduce stress or play a role in whether people show up for their procedures. And setting expectation around things like sexual intimacy play a big role in a person’s quality of life.
Even confident people who interview scientists for a living don’t always feel comfortable asking questions when they’re in the patient’s seat. Alan Alda described being flummoxed and afraid to ask questions about an oral surgery he was having. It ended up affecting his smile — as an actor, something he wished he’d understood.
While we can’t anticipate all patient, partner, and family concerns, we can learn to anticipate and proactively address many of them. This has benefits for both patients and clinicians.

For patients and families, it normalizes uncomfortable questions. When clinicians bring up these topics, people realize these must be common questions others have. It puts them at ease, and they feel more comfortable asking other questions.

When concerns are addressed up front, they don’t weigh on people’s minds, and it allows people to focus on the rest of the conversation instead of looking for the right opportunity to broach a topic. This can make conversations more patient centered and efficient – as people don’t spend time dancing around these questions.

It also demonstrates competence, which improves relationships and builds trust. And when people see their clinicians understand their worries and can predict their questions, they’re more likely to trust other information from them, like post-op instructions. 

Plus, when people’s informational needs are met, they’re less likely to go down rabbit holes conducting their own online research.

Become Psychic

Of course, healthcare teams can only do this when they know what people’s concerns are. So clinicians can learn to read minds — or as ePatient Dave says: let patients help! Ask people:

If you could tell something to others who will be having this procedure, or who are newly diagnosed with this condition, or are starting this medication, what do you wish you’d known or understood?

Also ask admins and others what questions they field from patients. I’m often surprised what questions never make it back to physicians. When researching abdominal hysterectomy years ago, most of the advising OB’s on the project hadn’t heard of “swelly belly,” even though it came up constantly in patient interviews and online forums. It was only after talking to a nurse who explained, “Women call about that all the time, but the doctors never hear it because we answer those calls.”

People are also more comfortable disclosing info about stigmatized challenges like post-op depression in online settings. So using survey tools can help gather candid info. Many clinicians are surprised to learn what’s weighing on people’s minds.

Then, proactively address these question and integrate them into patient resources. Don’t wait for people to bring these topics up. Too many people will never feel comfortable asking.

About the author

Geri Lynn Baumblatt

Geri Lynn Baumblatt

Geri works to improve relationships, communication, understanding, efficacy, outcomes, experience and wellbeing of patients, clinicians, and family caregivers. Her work incorporates principles from health literacy, decision and behavioral science, neuroscience and organizational design. She cofounded the Difference Collaborative to help employers address the growing needs of their employees who are family caregivers so they can work, care and thrive.