LEAD ARTICLE – APRIL 2019

Talking To Patients Or Clients

Lawyers and doctors have this capacity and duty in common. We have to converse at the outset, during the course of some form of liaison and at the time of completion, whether it be settlement or at the end of a therapeutic regimen.

From a medical perspective, and I suspect it is also true for lawyers, some do it better than others. Most lawyers and most doctors have an intelligence quotient well above average. Unfortunately, the IQ level does not necessarily equate closely with social intelligence. EQ, or the emotional ability to engage and liaise with people is also sometimes lacking.

From an orthopaedic surgical perspective, most of our liaisons are of a clinical nature. At the outset, we take a history, perform a full examination, review some ancillary investigations and then make a diagnosis. After that point has been reached accurately, a proper therapeutic regimen can be devised and actioned. Whilst the steps are slightly different, and obviously have different names, the process is probably similar in law.

All of us have a need to establish boundaries and create some barriers. These barriers can be of a social, professional or sexual nature. At a social level, it is probably best that we don’t engage too closely with our clients or patients. At a professional level, whilst aloofness is not necessarily ideal, some distance can give rise to greater objectivity and make the delivery of unsavoury or unpalatable news easier. The need for sexual boundaries speaks for itself.

When engaging in verbal discourse, there are many other parameters that can be of considerable use. I am referring here to warmth, empathy, genuineness and care.

Some of my colleagues, especially in orthopaedic surgery and especially the males, see these four qualities as a sign of weakness. Interestingly, whilst I have never really viewed them as being weak, I suspect that I did shy away from them in the first decade or so of my professional career. I was afraid that these empathetic signs may be misinterpreted. I was also afraid that when complications occurred (and as rare as they should be, they will always occur), my ability to deal with them professionally and objectively could be compromised.

With age, experience and having been a patient myself, I now see that all four of those qualities are very important. They should form part of our discourse regularly and from the outset.

As I look back upon my career, I think that in addition to medicolegal analyses, it has been the exchange and interchange with patients that has given me the greatest pleasure.

I hope you can say the same.