A Visit to the Doctor

Question: How do you know that you’ve got the “Toastmasters bug”? Answer: You feel an urge to ring the bell when the doctor asks you to say “ah.” For some people, the inability to remove their Toastmasters hat upon leaving the meeting starts after three to five years of membership. In my case, a fortuitous turn of events sped the process. Just two months after I joined the organization, at the dawn of 2000, I was diagnosed with breast cancer. As a result, my weekly Toastmasters meetings were paired with regular doctor visits.

This is the type of general evaluation – doctor’s visit as Toastmasters meeting – that used to play in my head when I left some of my doctors’ offices:

  • Our guests were greeted with a frown and pushed to speak hastily through the fleeting opening of a sliding translucent window at the front desk. They might look for another club.
  • The meeting started 20 minutes late, a substantial improvement over past weeks.
  • For inspiration, the broadcast of headline news through a blasting TV set on the wall might not be the right fit for the test coming next – blood pressure.
  • Attendees were left alone for periods extending from five to 20 minutes in one tiny, neon-lit room after another, dressed in used and discolored unisex open-front-or-back gowns. Not very confidence-inducing.
  • The Topicsmaster entered the room looking at his notes. No handshake, no smile, no eye contact. Connection is made difficult.

The World of the Patient
In his recent and fascinating book, Anti Cancer, Dr. David Servan-Schreiber writes, “When I found out I had a brain tumor, I discovered overnight a world that looked familiar but in fact I knew little about – the world of the patient. Like everyone else, you waited in the waiting room that as a doctor you had breezed through, head high, avoiding eye contact with patients so as not to be waylaid.”

I felt so depressed facing my own “patienthood” at the beginning of my long and still-ongoing cancer saga that I deserted the conventional medical system for three years, a decision I later regretted. When my cancer spread and I was re-examining my options, I realized that a big part of my aversion to the system was communication-related. As a cross-cultural communication consultant, it dawned on me that I was simply facing a different culture – the mainstream medical culture – and suffering from culture shock. All I had to do was use my expertise in bridging the cultural gap.

                    “Opportune silence will help prevent medical errors, one of
                    the five leading causes of death in the United States."

By then I had five years of active Toastmasters experience, including having been Vice President Education as well as president of my club – the Boca Raton Toastmasters in Boca Raton, Florida. I felt armed enough to give it another try. But this time, I would be in charge.

I developed strategies that have proven successful, allowing me the benefits of my doctor visits without the emotional side effects. Just as if I prepared to be the Toastmaster of a club meeting, I now work on every detail – from the way I project my image to the effectiveness of my communication and the organization of my records.

Here are a few useful tips:

When You are the Patient
Dress to heal. In Toastmasters we are encouraged to dress professionally. It projects power and authority. As strange as it may seem, I wear a suit when I visit the doctor. Even if you end up wrapped in the forget-my-dignity-open-back gown, a professional outfit will foster enhanced respect while you are dressed.

Bring someone with you. Have you noticed the number of guests who come to the doctor’s office accompanied by someone? It boosts their confidence and helps them compile information. It is very important to take someone with you to the doctor’s office. As patients, we are not always in our most clear state of mind, especially after an unpleasant diagnosis. We forget to ask critical questions and we miss information. Whoever you have brought with you will be more alert and able to take notes.

Use time wisely. Since we typically get the red light after somewhere between five and 15 minutes with the doctor, it is in our best interest to come prepared. We need to have our records organized as if we were the Toastmaster of the meeting, bring a list of comments and concerns as if we drafted a speech and underline the most important ones as if we were to give an evaluation. In summary, we need to be ready to discuss the most relevant issues in the least amount of time.

Make an impact. Organization, purpose and clarity in your speech will get you the audience’s attention and interest. If you apply the same skills with the doctor, he/she will be more inclined to treat you as an intelligent and valued patient.

Give room for silence. How many times have you struggled to concentrate on your one-minute written evaluation because the General Evaluator kept talking, oblivious to the need for quiet? And how many times have you asked questions or kept chatting while the doctor was writing his notes or your prescription, or while the nurse was taking your pulse? Consideration is critical in communication. Besides, opportune silence will help prevent medical errors, one of the five leading causes of death in the United States.

Be a Grammarian. The Word of the Day turns into a glossary when it comes to communicating effectively with the doctor. Researching your condition and becoming familiar with related medical terms will make you an active participant in your own recovery and may even save your life.

Thanks to a medical test that I had personally requested after reading about it online, I was able to receive, years later, a new therapy that I credit for my survival. Having the results at hand when my condition required immediate action saved my life. Today, patients team up with the doctor in decision-making, so learning new terminology is critical.

Connect. Connecting with your audience members involves showing them – with proper prior research, customized humor and stories, interaction, etc. – that they matter and that “you are one of them.” As soon as I step into a doctor’s office, I set myself on relationship-building mode. The simple acknowledgment, “Looks like a busy day!” works marvels at any level. I’ll comment on family pictures on desks, express gratitude whenever possible, make people laugh, inquire about their origins when I hear an accent, make note of their names, send personalized holiday and thank-you cards, and so on. When you show your listeners that you care about them you encourage their loyalty and engagement. Likewise, when you connect with your medical staff you reinforce their interest in you and raise their commitment level. Needless to say, you also elicit a shift in bedside manners, if necessary. 

When You are the Doctor
Promote congeniality. Every time I push the entrance door of my club meeting, a member standing on the other side greets me with a bright smile. Guests are so impressed by the welcoming atmosphere of the club that they recurrently mention it as one of the reasons that motivates them to join.
In my nearly 10-year cancer odyssey I’ve come across many doctor’s offices, and whenever the staff was friendly it made all the difference. I urge doctors to reflect on the importance of people skills when hiring and training their staff.

Go easy on newcomers. Some Toastmasters rules are specifically designed to avoid scaring away inexperienced speakers and guests. We don’t ring the bell for “ahs” when a guest is speaking or a new member gives the Ice Breaker, nor do we focus on gestures and eye contact at those early stages. We strongly secure the psychological safety of our “freshmen.”

Five days following an excruciatingly painful, anesthesia-free biopsy on my breast, I found myself waiting alone for 15 minutes in a bleached-white antiseptic room with bare walls. When my surgeon finally came, she stared at her notes for about three minutes before acknowledging my presence, and then blurted: “I don’t have good news for you, Ms. Ferreira.” She looked me in the eyes for the first time. “It’s malignant. I’m sorry.” And without missing a beat, “There is nothing else we can do but remove your breast along with 20 to 30 lymph nodes, and then give you chemotherapy. Here is some literature for you, and I’ll walk you to the front desk where we’ll set up an appointment and give you some plastic surgeons’ names.”

That’s when something short-circuited in my head and I took flight. As a doctor, you can’t change the facts, but using a gentle and supportive approach will lessen the impact and encourage a healing disposition in the mind of the patient.

Use the Oreo cookie method. (For those unfamiliar with the American Oreo-cookie analogy, think of crepes, baklavas, alfajores, linzer augen or Shanghai pancakes – any pastry that comes with a layer of dough on the top and bottom with filling in the middle). When we conduct a Toastmasters evaluation, we start by offering general positive comments, then we give suggestions for improvement, and we wrap up with encouraging remarks.

Four years ago, after one of my successive surgeons postulated that I had three to six months left to live, my oncologist managed to show me a light at the end of the tunnel. He started his “evaluation” by stating that it was not as dark as it seemed; that despite the severity of my state, there were new treatments I could try. Then he described the course of action. And the words he used to conclude still resonate in my mind: “Now your job is to think positive. Never lose hope.” Words meant with love never hurt anyone.

                    “Researching your condition and becoming familiar with related
                    medical terms will make you an active participant in your own
                    recovery and may even save your life."

Whether you are a patient or a health professional, you will find in your Toastmasters training myriad ideas to improve communication, increase effectiveness and find gratification in your mutual interaction. The key is to be proactive. Of course, you can’t anticipate every scenario. So what do you do in face of the unexpected? You draw from your Table Topics experience. This is how it worked for me over a year ago:

While I was waiting in his consultation room, my new primary doctor got an emergency call and had to leave the office. He appointed one of his colleagues to my care, who openly expressed his discontent about the situation and started reviewing my medical history in a rude manner. I just answered the questions, nonchalantly. Then he asked what I did for a living. And I heard myself reply, “I speak and write about doctor-patient communication.” He turned around in a snap, looked at me bewildered, shouted out, “Really!” and suddenly emerged as a delightful Prince Charming. I’ve been carrying that line in my toolbox ever since, but am happy to report I never had to use it again. Not all doctors’ offices are created equal. 

Florence Ferreira, ACB, CL, is a member of the Boca Raton Toastmasters in Boca Raton, Florida. A trilingual (English/Spanish/French) intercultural-communication consultant, Florence is the founder of www.SpeakGlobal.net and an inspirational speaker and writer. Reach her at f.ferreira@speakglobal.net.