What to say during shadowing

[batista_123]

Hello,
the doctor that i was shadowing said I appear to lack self-confidence and I shouldnt be so quiet with patients. It is true that I lack self-confidence and I am shy around people I dont know. but putting that aside, I dont even know what to say to patients.
the doctor is very outgoing and he likes to joke around with his patients. I am completely the opposite, I am serious. I know this is not good, but if I were a doctor I would just see the patient, treat him, goodbye. Not "how many children do you have?" "where does he go to school?" "oh, you went to the game, what was the score?" things like that. Once again, I know you need to make a relationship with the patient, and see them as a person not as a symptom. OK maybe if I was a doctor I would ask "how many children do you have?" but as a student, can i ask something like that? isnt that inappropriate?
As someone who knows nothing about medicine, and doesnt like to joke, what comments can I possibly make? And how do I know which comment is appropriate and which might sound rude or nosy?
i have nothing to say and even if i have something to say, i think it might be inappropriate and offend someone so i say nothing but patients sometimes tell me i am too quiet.
Also sometimes the doctor makes a joke on me, something like "oh this hernia is as big as Tom's head" (my name is Tom)
and the attention is now on me, and I say in my head "say something clever. say something funny."
but the problem is again
1. i have nothing to say
2. anything that comes to mind sounds rude
So i just smile and move on.

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[GellaBella]

Do you introduce yourself? Ask them how they are doing?

Back in the days when I worked in a Drs office while considering going MD I was always the person that brought the patient back into the room. Took the initial history, blood pressure, temp, pulse etc and then would stand in while the Dr was talking with the patients.

You really should work on building up a set of phrases that you say that can keep a conversation moving, if it doesn't come naturally to you.

I've known many people - friends, family, and patients that I met in that Drs office - who told me that their previous Dr never talked to them. That they felt uncomfortable because the Dr would just come in, treat them and leave. People want a Dr who seems interested in them and seems like they care about them. Even if its a specialist, they want to feel like they're being treated by a person. Not a machine. So I think its definitely something to work on. Just my 2 cents.

 

[Pedie Packs]

Well,that should be a great experience for you shadowing this doctor then! Pick up on the things he talks about and try join in on the convo... sports, the news, heck everyone shares the weather, you could talk about that haha. Simply reading the news is a good start so you have something to chime in with.

Don't fret, being able to communicate freely to people we don't know is something a lot of us need to develop on their own... most of us aren't lucky enough to be naturals. I'm glad you realize it's a necessary skill for a physician to have, so try put yourself out there and talk to these patients... just small talk before the doctor gets to work, remember not to interrupt or that could get awkward.

 

[aggie08]

Hello,
the doctor that i was shadowing said I appear to lack self-confidence and I shouldnt be so quiet with patients. It is true that I lack self-confidence and I am shy around people I dont know. but putting that aside, I dont even know what to say to patients.
the doctor is very outgoing and he likes to joke around with his patients. I am completely the opposite, I am serious. I know this is not good, but if I were a doctor I would just see the patient, treat him, goodbye. Not "how many children do you have?" "where does he go to school?" "oh, you went to the game, what was the score?" things like that. Once again, I know you need to make a relationship with the patient, and see them as a person not as a symptom. OK maybe if I was a doctor I would ask "how many children do you have?" but as a student, can i ask something like that? isnt that inappropriate?
As someone who knows nothing about medicine, and doesnt like to joke, what comments can I possibly make? And how do I know which comment is appropriate and which might sound rude or nosy?
i have nothing to say and even if i have something to say, i think it might be inappropriate and offend someone so i say nothing but patients sometimes tell me i am too quiet.

You don't have to be a silent observer unless the doctor tells you to be. Obviously he wants you interacting with patients, so do it. Walk in, introduce yourself as a student, shake a hand, laugh at the jokes....just don't be awkward. If a situation comes up and you have a question, ask it.

I would feel awkward, too, if I was a patient and you just stared at me the whole time.

 

[batista_123]

Do you introduce yourself? Ask them how they are doing?

Back in the days when I worked in a Drs office while considering going MD I was always the person that brought the patient back into the room. Took the initial history, blood pressure, temp, pulse etc and then would stand in while the Dr was talking with the patients.

You really should work on building up a set of phrases that you say that can keep a conversation moving, if it doesn't come naturally to you.

I've known many people - friends, family, and patients that I met in that Drs office - who told me that their previous Dr never talked to them. That they felt uncomfortable because the Dr would just come in, treat them and leave. People want a Dr who seems interested in them and seems like they care about them. Even if its a specialist, they want to feel like they're being treated by a person. Not a machine. So I think its definitely something to work on. Just my 2 cents.

the doctor is usually the one who introduces me, and then i say hi. that's it. for patient history, there is a nurse who does all that. so what phrases do you recommend?
Also, when you are leaving, "nice to meet you, take care" is fine?

 

[batista_123]

OK I know i need to talk, but I HAVE NOTHING TO SAY. that is the problem.

 

[greatnt249]

Hello,
the doctor that i was shadowing said I appear to lack self-confidence and I shouldnt be so quiet with patients. It is true that I lack self-confidence and I am shy around people I dont know. but putting that aside, I dont even know what to say to patients.
the doctor is very outgoing and he likes to joke around with his patients. I am completely the opposite, I am serious. I know this is not good, but if I were a doctor I would just see the patient, treat him, goodbye. Not "how many children do you have?" "where does he go to school?" "oh, you went to the game, what was the score?" things like that. Once again, I know you need to make a relationship with the patient, and see them as a person not as a symptom. OK maybe if I was a doctor I would ask "how many children do you have?" but as a student, can i ask something like that? isnt that inappropriate?
As someone who knows nothing about medicine, and doesnt like to joke, what comments can I possibly make? And how do I know which comment is appropriate and which might sound rude or nosy?
i have nothing to say and even if i have something to say, i think it might be inappropriate and offend someone so i say nothing but patients sometimes tell me i am too quiet.
Also sometimes the doctor makes a joke on me, something like "oh this hernia is as big as Tom's head" (my name is Tom)
and the attention is now on me, and I say in my head "say something clever. say something funny."
but the problem is again
1. i have nothing to say
2. anything that comes to mind sounds rude
So i just smile and move on.

The questions you perceive to lack relevance can, in fact, provide many clues about a patient's background. You're not expected to know how to conduct a patient history, but if you have a question about methods, don't be too shy to ask.

 

[notoriousmoops]

If your demeanor was poor enough for the doctor to actually bring it up to you, then you need a little work with your social skills. Judging by your style, perhaps a rigid set of social guidelines would work for you.

Step I:When shadowing a doctor, stride into the room( with a tall posture and smile on your face) and make eye contact with the patient (and family) while the doctor introduces you (as he introduces you, they are going to be looking over at you, so don't be caught looking at the floor or ceiling).

Step II: Say "Hi, I'm [name], it's nice to meet you" and shake his or her hand (also look to the family, they may offer a handshake as well).

Step III: The doctor will proceed to examine the patient. If the doctor or the patient makes jokes, laugh. If you don't find them funny, you still need to smile and try to laugh. When someone tells a joke, they look around to see the response. If the doctor or patient see Mr. Tom "Stonewall" in the corner with a frown on his face right after a joke has been told, that will impact you negatively.

Step IV: As you leave, shake the patient's hand, smile, and say "It was so nice to meet you" or "It was nice meeting you." He or she may wish you luck with your studies. Proceed to confidently stride out of the room (be careful, if you strut, you may be overdoing it).

You are not there to learn the science behind the treatment, you are there to observe the doctor-patient relationship/interaction. Don't focus on the minutiae, focus on smiling and enjoying the experience.

Overall, smile, be confident, stand tall, make eye contact, and try to have a great time. These few things will help you in your clinical shadowing, medical school interviews, romantic relationships, and life in general.

 

[notoriousmoops]

Also sometimes the doctor makes a joke on me, something like "oh this hernia is as big as Tom's head" (my name is Tom)
and the attention is now on me, and I say in my head "say something clever. say something funny."
but the problem is again
1. i have nothing to say
2. anything that comes to mind sounds rude
So i just smile and move on.

Tom, you don't need to "say" anything in this situation. In this situation, laughing would probably be the best option.

 

[greatnt249]

If your demeanor was poor enough for the doctor to actually bring it up to you, then you need a little work with your social skills. Judging by your style, perhaps a rigid set of social guidelines would work for you.

Step I:When shadowing a doctor, stride into the room( with a tall posture and smile on your face) and make eye contact with the patient (and family) while the doctor introduces you (as he introduces you, they are going to be looking over at you, so don't be caught looking at the floor or ceiling).

Step II: Say "Hi, I'm [name], it's nice to meet you" and shake his or her hand (also look to the family, they may offer a handshake as well).

Step III: The doctor will proceed to examine the patient. If the doctor or the patient makes jokes, laugh. If you don't find them funny, you still need to smile and try to laugh. When someone tells a joke, they look around to see the response. If the doctor or patient see Mr. Tom "Stonewall" in the corner with a frown on his face right after a joke has been told, that will impact you negatively.

Step IV: As you leave, shake the patient's hand, smile, and say "It was so nice to meet you" or "It was nice meeting you." He or she may wish you luck with your studies. Proceed to confidently stride out of the room (be careful, if you strut, you may be overdoing it).

You are not there to learn the science behind the treatment, you are there to observe the doctor-patient relationship/interaction. Don't focus on the minutiae, focus on smiling and enjoying the experience.

Overall, smile, be confident, stand tall, make eye contact, and try to have a great time. These few things will help you in your clinical shadowing, medical school interviews, romantic relationships, and life in general.

And wash your hands before/after you leave the room if you do shake hands with the patient. Sounds lame, but you never know what you/they are carrying.

 

[bannie22]

no idea. when i was shadowing i just either said hi when the patient came in, or smiled and nodded.
but other than that i just sit back, relax, until the doctor calls upon me to do something, say like feel the pacemaker..


ure supposed to reduce handshakes anyway. protocol.

and i got to sit down too.

 

[bannie22]

and if u have nothing to say. u have nothing to say.

screw the ppl that think otherwise.


ppl who talk too much annoy me anyway. sometimes its better not to say anything. a smile suffices.

 

[batista_123]

thank you, notoriousmoops,
thats exactly what i wanted, step by step instructions.

 

[BMEZephyr]

Okay. I understand exactly what you're going through because I've been shadowing in a mentorship program for about 2.5 years in high school.

First of all, your priority is to build a good, open, communicative relationship with the doctor you will be shadowing. How can you even be regularly introduced to patients if the doctor isn't sure of who you are, or how well you can communicate with patients? If you build a good a relationship with your doctor, as well as some of hospital staff members, they will in return try to expose you to as many patients as possible which will in turn, make you more affable to patients.

If there seems to be a bit of down time, talk to the patient about his/her symptoms, how he's feeling, how were his experience with previous doctors, and just talk about simple things. You don't have to conduct experiments on psychoanalysis or complete a pt. history/physical. You also have to consider the mental/physical state of the patient. When I was in the ER, most of the patients were screaming, complete tools, or just too much in pain to be able to talk. It would obviously annoy the miserable crap out of them if you started discussing Obama's plans for reform or the Nicks' game when their kidneys are about to explode into oblivion.

So remember, context is very important.

When I used to shadow, I kept talking with my doctor and asked him questions in between each patient interaction. If I were to interject or communicate with a patient who's obviously being examined by the doc, I would be disrupting my doc's time and would therefore come out as an annoying pre-med. NOT GOOD.

And try to come up with unique ways to introduce yourself to other people in the hospital (not limited to patients). A perfect way to connect with patients for example, would be to say: "Wow, you know something? You remind me a lot about my grandfather/mother/aunt/whoever. They were always kind to people no matter what situation they were in, and appreciated what others did for them. That's something I really admire, you know?"

That right there will make the patient extremely satisfied and more at ease. There's a relation and similarity being drawn between two otherwise different parties. When one can associate or relate to others, it reduces the tension/anxiety that would exist between who were once strangers.

And also remember, it's not as much about the quantity or volume of things you say. What's more important is if you can time certain comments and say them at the right moment. Just a few kind words can make a huge difference. Don't be aloof or look like you'd pay a million bucks to be anywhere but near the patient. Smile, exude confidence, inquire, and connect. And yes, it is NOT about the science. That's what classes/med school is for.

I could go on about this.

 

[BMEZephyr]

Oh and as for the comment the doctor made about you having a head the size of a hernia, you can come off as completely innocuous by just playing along with the flow of his comments.

I would have said this:

"Hey, my head is only like that on wednesdays. If you think that's big, check out some of the nurses here."

You're pretty much absorbing the witticism that the doc made on you, amplifying it, and harmlessly reflecting it to a different party. No ones feelings are hurt.

 

[bannie22]

^

i think thats just lame...

 

[armybound]

no idea. when i was shadowing i just either said hi when the patient came in, or smiled and nodded.
but other than that i just sit back, relax, until the doctor calls upon me to do something, say like feel the pacemaker..


ure supposed to reduce handshakes anyway. protocol.

and i got to sit down too.

protocol to reduce handshakes? what's that mean?

 

[BMEZephyr]

^

i think thats just lame...

It may be, but I've used it plenty times. It works and that's all I care about. I'm not there for professional comedy.

 

[jd23]

^

i think thats just lame...

i think your mom's lame

edit: batista, try using 'your mom' jokes with patients and your doctor--it might improve their opinion of you

 

[BMEZephyr]

Hahaha. Try it on those psych patients and you'll make note of very interesting things.

 

[greatnt249]

no idea. when i was shadowing i just either said hi when the patient came in, or smiled and nodded.
but other than that i just sit back, relax, until the doctor calls upon me to do something, say like feel the pacemaker..


ure supposed to reduce handshakes anyway. protocol.

and i got to sit down too.

Please...enlighten me as to what this "reduced handshake" protocol is.

and if u have nothing to say. u have nothing to say.

screw the ppl that think otherwise.


ppl who talk too much annoy me anyway. sometimes its better not to say anything. a smile suffices.

You're going to deal with a lot of things that annoy you or "grind your gears" in medicine; might as well suck it up and deal with it now.

 

[BMEZephyr]

Please...enlighten me as to what this "reduced handshake" protocol is.

I think what he meant to say is that you want to reduce unnecessary contact with patients as much as possible (especially as a volunteer or premed. shadower). Personally, I never found myself handshaking with patients (or with their family) and always had gloves on before ANY patient contact.

You're going to deal with a lot of things that annoy you or "grind your gears" in medicine; might as well suck it up and deal with it now.

This one definitely a If you can't handle the intensity that the profession calls for, as well as the idiocy within patients that never seem to wane, become a banker or a surfer instead.

 

[armybound]

I think what he meant to say is that you want to reduce unnecessary contact with patients as much as possible (especially as a volunteer or premed. shadower). Personally, I never found myself handshaking with patients (or with their family) and always had gloves on before ANY patient contact.

just fyi, this is not the case as a student or physician. it's standard practice (insofar as it's expected of you on your boards) to walk into a room, wash your hands, introduce yourself to your patient, and shake their hand. you do not wear gloves unless you're touching mucous membranes or body fluids

 

[ILikeDrugs]

I had a patients husband tell me, "So, are you applying to USC or UCLA? I'm a UCLA man myself. Cause as far as I'm concerned, the only good trojan is a used trojan, if ya know what I mean." All for of us had a good laugh.

Try not to be so anal op. You can be professional and still have fun aka a human. Sure, there might be patients who don't want to joke around but that doesn't mean that everyone will be that exact same way.

 

[endlesswinter]

I think I'm similar to you OP, I am pretty quiet/introverted.

When I've shadowed the doctor has occasionally left me with the patient while he's gone out to look for something and I have a hard time knowing what to talk about. Sometimes I would ask about how they handle their medical situation, but I felt that might be a bit personal so then I started just having casual conversation about the weather/baseball whatever lol.

Also about half of them asked how old I was and commented on how young I look but at least it was something to talk about.

In between patients the questions I had for the doctor were mostly scientific, ie "what is the mechanism of that drug" etc. which I got the impression he though was strange, so I'm not really sure there. I'm definitely going to continue working on it.

 

[azrael87]

I know a lot of people like you, OP. In fact, in my early teens I was exactly like you (not implying you're young, just that I've changed quite a bit). You seem to really overthink what to do in social situations. My best advice is to take it one step at a time.

When the doc takes you in to see a patient and you don't know what to say, then just LISTEN. Don't worry about what you should say, just worry about what the doctor and patient are saying. If you want to ask a question or make a comment, but feel it may be inappropriate then make note of it. Wait until you and the doctor leave the patient, then ask him/her if it would have been alright if you had asked/said "(insert question/comment here)". Keep an open dialogue with the physician you're shadowing when you aren't with patients. They want to answer your questions and educate you on the ways of the world. They wouldn't have agreed to be shadowed otherwise. If you are wondering something, anything, ask the doctor about it when you get the chance. In fact, any question you're thinking of putting up on these forums, ask the doctor first.

Once you get a feel for what is and isn't okay to do and say, you can start going with the flow when you're with a patient. In my experience there isn't much to say unless you're being addressed by the doctor or patient, anyway.

Also, this may not work if you aren't good at it or try too hard, but it may help to imagine someone you know that is professional and confident. Then, try to act like them. When you're nervous and know you should be confident, just emulate that person you know. At first it will feel a little unnatural, but eventually you'll get used to it and be able to find a middle ground where you're acting natural and still maintaining confidence.

In general, you also need to worry a little bit less about what people MIGHT think of you. You aren't going to go hang out with your patients after the doc examines them. You probably aren't even going to see them again afterwards. So it's really not that big of a deal if you make a bad joke since it won't have any lasting effect.

 

[CopToEM]

Sounds to me like the physician's method of breaking the nervousness is to kid around. Patients are generally very nervous, depending on the situation, and if you appear nervous or introverted it's not going to improve the situation. I'm sure that's why the physician mentioned it to you.

I think you should definitely thank the patient for allowing you to meet with them. After all, you're not their physician, and you're taking part in a very personal part of their life. I'm certain it makes them uncomfortable to be a fly on the wall.

Just think of them as old friends - it's not unprofessional to cut good taste jokes and talk about happenings to break the ice.

 

[greatnt249]

Also about half of them asked how old I was and commented on how young I look but at least it was something to talk about.

Patients will do things to make you feel awkward; try getting hit on by some of the older female patients.

 

[medicalmatins]

I'm shadowing someone tomorrow; some of this advice is really useful! Thanks, all, and have a blessed Christmas!

 

[The right Path]

and if u have nothing to say. u have nothing to say.

screw the ppl that think otherwise.


ppl who talk too much annoy me anyway. sometimes its better not to say anything. a smile suffices.

^

i think thats just lame...

Wow. You should worry about how you will come across in an interview. You basically stated "Screw the people that think social skills are important and effort should be made to improve them. That's lame". That attitude is as ridiculous as telling someone that earning a high gpa is lame and study for the MCAT?- Screw that.

Props to the OP who sought advice and responded to it graciously. The nice thing about the MCAT is that performance is easily measured. Social skills are just as important as MCAT skills, just not quite so easy to measure. Fortunately, they also have another similarity- study and practice do improve performance.

just fyi, this is not the case as a student or physician. it's standard practice (insofar as it's expected of you on your boards) to walk into a room, wash your hands, introduce yourself to your patient, and shake their hand. you do not wear gloves unless you're touching mucous membranes or body fluids

Thank you for pointing out the proper use of PPE (personal protective equipment- that is gloves, etc.)!!

Wearing gloves is not appropriate for shaking hands, and it is also not appropriate to avoid contact with your patients! WTF?

And even for the proper circumstances which involve wearing gloves, you still need to wash your damn hands!!!

 

[YouNeverKnow22]

Nothing. Only speak when your spoken to. But don't be a wall, if the doc wants you to interact then go for it.

 

[surftheiop]

I've had a fair amount of semi-awkward moments because the MD I shadow with often leaves me in the room with a patient/family when she goes to grab some paper work or something.

This is in Peds so during this time I usually
1) play with some toys with the patient if they are young (sadly not option for you if your not shadowing in peds )
2) Talk to the parents about the weather.
3) Talk to the patient about school, hobbies if they are little older.

 

[7starmantis]

thank you, notoriousmoops,
thats exactly what i wanted, step by step instructions.

Seriously, it might behoove you to work on social skills. Your going to need them throughout your education, career, and life. Get out and put yourself in socially awkward situations....great practice

This saddens me, have we seriously made our pre-meds so neurotic they have lost social skills and/or value in gaining them? This has been a big plus in being a non-trad I think.

Haha, about the hernia thing just say something like, "meh, I've seen plenty that big, when you find one as big as your mother's head, that I'm interested in seeing".

 

[apumic]

Yikes, OP. Just start talking w/ the pt. As has been said, if the doc is ok with you engaging the pts, go for it! Shadowing is always a little awkward at first but the staff aren't going to look down on you for getting in there and asking questions. Pts know that you are a student, so they're not going to mind you engaging them, asking questions of them or the doc, taking part in small talk, joking around, etc. Do you engage the staff more than the pts? You should at least be able to engage them pretty easily when, for instance, you're sitting in the doctor's lounge during lunch or in the nurses' station while the doc charts something or checks a pt chart, x-ray, MRI, etc. It's all about engaging. Just get there. You're going to make mistakes -- that's how we human beings learn. It's good for you, so good luck!