Lessons from Master Clinicians: Listen to Your Patients

Dr. Jonas

Dr. Jonas: It is important to listen very carefully to your patients and be mindful and present in each encounter. Before I go into a room with a patient, I mentally prepare myself to be ready for the visit. Many things may be happening in life—pagers buzzing, a child sick at home, etc.—but focusing on the patient in front of me helps me truly listen to them. This is important [because] patients provide a great deal of essential clues and pieces of information that help contribute to evaluation of their symptoms.

I try to enter each visit with an open mind and draw my own conclusions based on what they tell me. I attempt to not ignore parts of the story that do not fit into my preconceived notions; doing so may lead [us] down the wrong path or prevent a breakthrough in thinking about that patient’s story.

There is a lot of uncertainty in rheumatology, and I do not neglect this fact. When I do not know something, I readily admit this to the patient and both make a note to myself and make a promise to the patient to fill this gap in knowledge.

TR: What lessons have you learned from patients that have contributed to your own growth as a clinician?

Dr. Jonas: Patients know so much, and we give them no credit for this. With challenging and difficult cases, the times when I can achieve a breakthrough and make progress occur when I am able to truly pay attention to what the patient is saying. Patients will recognize this and tell me, ‘You really listened to what I have to say.’ It does not take a lot of time to listen intently. It also makes you more believable when you ask a patient to take a next step in his or her workup or care.

I have also learned it is important to meet patients where they are and go along on the journey with them. We must not assume that we know the patient’s goals and expectations; we often have lofty goals for what [represents] success, and patients may have more modest and practical goals. It is, therefore, important to understand what patients want out of their treatment.

We should also consider how giving a new diagnosis to patients greatly affects their lives and their self-perception, and I have seen that it is worth taking the up-front time to let patients discuss these feelings with us as they learn more about their condition.

TR: What are the specific areas of triumph and challenges facing women seeking to become leading clinicians in the field of rheumatology—and in medicine in general?

Dr. Jonas: The biggest issue over the course of my career—at least in the beginning—was the relative lack of female role models in clinical and leadership positions. There were not a lot of women who we could look at and say, ‘This is the path I want to be on.’ This has improved, and rheumatology has been particularly good in evolving as a field, but there are still not enough women in the highest leadership roles.

Many of us have had strong competing priorities with professional and personal goals; men also often find this to be a challenge. Families are somewhat more egalitarian these days, and if everyone takes care of family life equally, this helps men and women share responsibilities. This is a system problem, and we are slowly getting better with this issue as we continue to address it in academic medicine and beyond.