Active Listening And Deep Thinking As Essential Skills For Clinicians Or Stay Home:
Complex cases without a known cause or solution require a unique approach. The approach includes the essential skills of active listening and deep thinking together with collaborative or shared decision making.
We call this “RCM’s team huddle”. This creates a sense of accomplishment and higher levels of engagement when working together on a complex problem. Don’t forget the patient is also a partner in this process.
what does not work with complex cases is quick thinking and simple heuristics. If the answer is not obvious, then the doctor might refer the case to another doctor. The lack of a quick answer is felt by some doctors to be a personal failure or lack of competence. Which it is not. The struggle to define the root cause and an actionable solution is hard and takes time. It is not a lack of competence if more time is required to resolve the matter.
Dorothy from Vancouver had been sick for about 2 years with a number of vague symptoms.
Saw 16 doctors in pursuit of answers.
The family retained RCM and the process was.
A hunch lead to a google search with the key words: silicone breast implants and auto-immune diseases. Out popped “Shoenfeld’s syndrome”. I emailed Dr Yehuda Shoenfeld in Tel Aviv. He told me that I didn’t need him He said to call Dr Cohen in Edmonton. He is the world’s expert in ASIA.
Our client went to Edmonton. Saw Dr Cohen who confirmed this to be ASIA. It was a great step forward in defining the problem and organizing the solution which involved removal of the source of silicone.
The Lesson Learned:
Complex cases do not have linear processes. The path to a solution can be circuitous and lead to a number of dead ends.
A creative process might be required. Then the epiphany arises and a sense of real accomplishment.
Patients might help their doctors to engage more actively, to think more deeply and to be more collaborative in pursuit of the solution.