On outpatient internal med, being chatty has somehow become a virtue.
In every specialty clinic I’ve been in, I’ve gotten in trouble because I can’t keep my patient conversations short enough. My personal philosophy is that I shouldn’t ask people sensitive information about their health until I at least know if a) the weather is still good/bad, b) they had a hard time parking, or c) they have discovered that the cafeteria sells sweet potato fries. At least, I wouldn’t want to share any personal information with someone who hadn’t at least spent two minutes chatting before we dive into the good stuff.
And on most rotations, this is a problem, especially clinics that have anything to do with surgery. My attendings do not care, as a general rule, that their patient’s dog recently died, or that their grandson is starring in Bye Bye Birdie, or whatever piece of trivia I had picked up while I am supposed to be asking about chest pain and bowel movements. When I was on one rotation, the residents actually started paging me seven minutes into each patient encounter to tell me it was time to come back to the workroom. Seven minutes?? What can you actually learn about a person in seven minutes?
On internal med and family practice, though, I have found my forte. I am not only allowed to build patient rapport by making random conversation, but it seems to be encouraged. The Internal med staff seems to like the trivia. For example, reporting that the most recent patient not only sewed his own fur coat, but personally trapped and killed the twenty beavers that were used to make it. To me, this obviously has to be part of the patient presentation, because that is remarkable. And I was expecting to be reprimanded when my attending walked in midway through a patient visit, only to find the patient carefully explaining to me exactly how to make bacon candy. But no, he sat down and patiently waited for this important conversation to be completed before we got down to the medical content.
Everyone talks about how each specialty has their own culture, and it’s completely true. In internal med, the physicians are very thoughtful and thorough, and like to think through each problem as carefully as possible. And patient rapport seems to be incredibly important. It makes sense – if you’re the one talking your patient into taking their medications and doing something as unpleasant as a colonoscopy, your patients have to trust you. And for most people, sometimes that is as simple as asking about how their dog is doing.
Read more experiences from current medical students. Subscribe to our blog!
All of the opinions expressed here are the author’s and hers alone, and do not represent necessarily those of Kaplan or its employees.