Don’t you talk back to me! (Or, why this *isn’t* always advice worth taking!)

I think it was often the look on my face. I can’t really remember ever “talking back” to an adult, but it’s hard to imagine any kid not wanting to at some point. I suspect there must have been something on my face that indicated I wanted to “talk back” that caused my grandmother or my dad to shake a finger and issue that warning.

 

It turns out that there are some times though when talking back might actually be a good thing.

 

Many counselors are trained in a technique called mirroring, when they repeat back (sometimes paraphrasing, sometimes word for word) what their client has just said to them. While some people may experience that as annoying (is there an echo in here?), it can also be a way to demonstrate that a person has been listening.

 

So how might that work when you’re with your doctor?

 

Some doctors are trained in a similar technique called a “teach back.” After explaining a diagnosis or treatment to a patient, they invite the patient to repeat back what they’ve heard. According to the Agency for Healthcare Research and Quality, studies have shown that 40-80% of the medical information patients are told during office visits is forgotten immediately, and nearly half of the information retained is incorrect.

 

When a doctor invites a patient to “talk back” the physician is really learning what they didn’t explain clearly (medical jargon, anyone?). As one doctor wrote,

 

“With one mother and her child, I concluded the visit by saying ‘so tell me what you are going to do when you get home.’…She could not tell me what instructions I had just given her. I explained the instructions again and then she was able to teach them back to me… I had no idea she did not understand… I was so wrapped up in delivering the message that I did not realize it wasn’t being received”.

—Pediatric office

 

When a patient is able to explain in their own words what their doctor said, and the doctor confirms it, three outcomes typically occur:

 

  • Patients better follow the proposed treatment.
  • Call backs and cancelled appointments decrease.
  • Patient satisfaction and treatment outcomes are improved.

 

How much time does this take? I couldn’t find any “data” on this, but in observing this process, it may add a few minutes to a medical encounter. Unfortunately, most doctors, already pressed for time, rarely invite a teach back. I know in my own experience as a patient, I’ve never had a doctor ask me to share what I understood.

 

So what’s a patient to do? Talk Back! If your doctor doesn’t offer it, invite your own teach back.

 

“Doctor, thank you. I think this is what I just heard you say. You’re going to call my insurance company to get this medication approved. When they’ve approved it, the specialty pharmacy will call me to arrange delivery. I should use two doses for the first four weeks, and then I drop to one dose every four weeks. How long should I wait to hear back from you? And I see you again in 12 weeks after starting the medication. Is that right?”

 

Sometimes we heard it right; sometimes the doctor will clarify. Will your doctor see your “talking back” as rude? Most don’t. But even if a doctor doesn’t see value in your talking back to them, knowing that you’ve improved your chances of a good outcome is reason enough to do it.

 

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