Health Source 2017

BE OPEN WHEN TALKING
TO DERMATOLOGIST
Susan Hammerling,
FOR FLORIDA TODAY
After practicing dermatology for
more than 15 years, I’ve learned
many things from my patients, especially
how important communication
is. Sometimes a patient will present
us with something that we think is not
significant, but they are self conscious about
and it makes them
anxious or avoid
social situations.
As health care
providers, we need
to get a thorough
history on why the
patient is here and
what motivates
them to be here.
It’s not necessary
to spend an entire
office visit doing
a psychological
evaluation, but it
needs to be part of the patient history.
First, we need to validate the patients’ feelings
whether it be fear, anxiety or skepticism
and let them know we take their problem seriously.
Open-minded communication is key to
establishing a successful office visit by letting
the patient know they can ask questions and
be part of the treatment plan. By letting the
patient know there is an open line of communication,
they will feel more comfortable in
disclosing their history to you.
Second, eye contact with the patient is important
and can result in a more honest and
forthcoming statement from the patient. In
addition, by observing the patient’s body language,
one can learn a lot about the patient’s
state of mind — whether they smile, make
eye contact or have visible or no affect. Many
times the patient may appear being rude or
aloof but instead they are depressed.
Third, it’s important to understand our
patients’ fears, hopes and expectations. Lots
of times they have identifiable emotional reactions
such as being anxious or experiencing
anger or depression.
However, it doesn’t always manifest in classic
ways. In order to communicate with patients
successfully and make sure a treatment
plan works, health care providers need to take
the time and assess a patients’ motivations.
Many times, patients fear their skin problems
will get worse, intensify or never go
away, causing them social anxiety or avoiding
social activities.
Sometimes as providers, we do not understand
the motivation of the patient and
assume the patient wants to be there. For
example, a
parent brings
in their teenager
for acne
on the face but
the teen has
no interest in
being there. Or
some patients’
motivations are
that they want
a modest improvement
of
their condition
versus someone
who has an unrealistic expectation.
Finally, a thorough history is a crucial part
of the correct diagnosis and successful treatment
of the patient. Many times a patient
will present to the dermatology office with a
specific problem and answer the health care
provider with one answer that is inaccurate.
An example of this is, when asking a patient
what creams they are applying to their body
and they respond by saying nothing. After
10 minutes of interviewing the patient they
disclose they are using nine different creams
their friends or neighbors gave them.
They defend their answer of stating they
are using nothing by saying, “nothing has
changed.”
Or I may ask what medications they take
and a common response I get is, “a small
white pill in a white bottle with a really long
name.”
In conclusion, by writing down specific
questions before the office visit regarding
your skin condition and a list of previous
medications tried, this can save many office
visits and co-pays by providing the health
care provider with the most accurate information.
Susan R. Hammerling, PA, MPAS, DFAAPA,
works at Florida Dermatology Associates in
Palm Bay.