I read an article today that suggests a specific and interesting application of Clean Language skills entitled “Diagnosis: What Doctors Are Missing’, by Jerome Groopman. He describes the prevalence today of doctors diagnosing and determining treatments based on test results—lots of them—rather than on interviewing the actual patient.
Groopman says,”The most seasoned clinicians teach that the patient tells you his diagnosis if only you know how to listen. The clinical history, beyond all other aspects of information gathering, hold the most clues. And it is this part of medicine–the patient’s narrative, the onset and tempo of the illness, the factors that exacerbated the symptoms and those that ameliorated them, the foods the patient ate, the clothes he wore, the people he worked with, the trips he took, the myriad of other events that occurred before, during, and after the malady–that are as vital as any DNA analysis or MRI investigation.” New York Times Book Review, Nov. 5, 2009, Vol. LVI, No. 17
Groopman quotes research that concluded that misdiagnoses often occur because of false assumptions the doctors made that set them on the wrong track. And once they were on it, they were no longer as attentive to other possibilities.
“We most need a discerning doctor when a diagnosis is not obvious, when the clues are confusing, when initial test are inconclusive. No simple technology can serve as a surrogate for the probing human mind.”
And a probing mind is well-served by learning Clean Language—a questioning process that uses primarily the patient’s exact words and keeps the facilitator’s (in this case the doctor’s) assumptions to a minimum. When a doctor learns to repeat a patient’s exact words, s/he learns to listen with precision, and will notice things that others readily miss. S/he’ll be surprised to learn how much knowing there is in a patient’s word choice, often just below the patient’s conscious awareness. The Clean Language process zooms attention in on details and zooms attention out to the larger context; new information can emerge very quickly. Clean Language can be used to explore and clarify, to sequence events or symptoms, and to explore what’s important to the patient, both in terms of treatment and life style issues, to name but a few uses.
Of course, they aren’t the only questions or approach a doctor might use, but learning to listen this way, training to recognize one’s assumptions, and developing a way to engage with a patient that makes the patient feel truly heard and respected, while eliciting meaningful information, are skills that could enhance the doctor/patient relationship and the effectiveness of any doctor.