The Importance of Being Honest

The Importance of Being Honest

As a society we are inpatient. It is in our nature. We place great value on things being done quickly and speedily. If there is a quicker alternative, more often than not we will take it. This is especially true of people who are in pain or have suffered an injury. As health professionals, some of the most common questions that are often asked of us when interacting with patients will involve a time based component:

“How long will it take to heal?”

“How long will it hurt for?”

“How long will it before I can return to doing activity x or y?”

These three questions (or any variation upon them) are extremely important to the patient (and as a result are the most frequently asked). The patient/health professional relationship can live or die by how the health professional chooses to respond to these questions and by how the patient responds to the the health professionals answers. These questions are of great importance to the patient. Being in pain is indeed an unpleasant experience. Therefore, having a rough timeframe of when the pain might end  is one of the next most frequent and perfectly rational questions a patient will ask.


The Six Week Ambiguity Paradigm

Answering these questions can be extremely hard, especially with patient expectations weighing down heavily upon the health professional. As a result, health professionals will give their patients an approximate estimate, an estimate which can often leave a patient feeling disappointed when the deadline created by this estimate are often not met. Frequently I have heard phrases such as “around six weeks” and “you will be back to normal in no time”. While it is essential that a health professional is positive with a patient about their recovery and management, being naively positive makes you no better than the average politician as you threaten to over promise and are more likely to under deliver.

These estimates can be more harmful than helpful due to their ambiguity, especially when the patient's recovery is not matching the health professionals initial prediction. This can leave the patient feeling mislead and frustrated and may cause a lack of trust in what the patient considers the health professional’s “expert opinion”.


I Googled this...

Health professionals are not the sole cause of blame when it comes to the amount of patient misinformation that is available. In an age where the word Google has successfully transitioned from a noun to a verb the average patient is freely able to browse information online in relation to their prognosis whether it is on their smartphone or desktop. To add to the amount of information that is freely available online, it is not uncommon for patients to get a “second opinion” from friends and family. Sometimes, years of undergraduate education (2-4 years dependent on your entry pathway) and placement/work experience cannot stand against the statement “My friend who is a sports therapist says…”.

As a result of the plethora of misinformation available from a multitude of sources health professionals find themselves correcting patient knowledge expectations more and more. The poor understanding of their recovery will often frustrate patients and can often lead to the patient believing they need a second opinion or further investigation, something that is not warranted most of the time. While it may be something of an uphill battle to manage these expectations it is possible.  To ensure you can win this battle it is important you know what you are talking about.


Be Honest and Know Your Stuff

It may seem logical to give a time frame for a patient's recovery, but when thinking about the many variables which can influence a patient’s recovery it can be tempting to take a guess. Managing the patient’s expectations is a vital aspect of patient care. Managing that patient’s expectations with a guess can therefore be a dangerous game. It is important to be honest with the patient. Having a good understanding of the biological healing process can be a good starting point in instructing patients on possible recovery times but it is important to stress that these recovery times are not set in stone and can be easily subject to change.  To further this, knowing the differing recovery times for bones, muscles, ligaments and tendons based on the severity of an injury will allow a health professional to give an educated guess as a guideline.Having greater knowledge of recovery times is extremely important as it improves a health professional's confidence as well the level of confidence the patient places in the health professional as well helping to strengthen the patient/health professional relationship.


It is also important to place emphasis on the word “guideline” as everyone is different and recovery times do not subscribe to the idea of a set timeline for recovery. Estimated recovery times are to be used as a flexible guide and are not set in stone. Relaying this message to the patient is also of great importance. Knowledge of recovery times will also increase with experience and repeated contact with patients who have similar injuries will enhance a professional’s ability to answer the above all important questions.


Tell It Like It Is

Giving honest and reliable time frames to a patient for their recovery is easy to do, and admittedly at times you may feel like guessing but the key message I have tried to impart in this blog post is not to guess. Guessing and being wrong can have serious implications for the health professional/patient relationship, most importantly a loss of trust. There is nothing wrong with not giving the patient the concrete answer they demand as long as you explain your reasoning why.

In conclusion, giving a patient an accurate time frame for their recovery can be an impossible task at times. In an age where we constantly demand more in terms of speed and effectiveness in every aspect of our life we can become frustrated with our bodies inability to keep pace and at the amount of time it takes for our bodies to heal. Sometimes it is better just to say “I don’t know” but not in as few words. The key things I wish for you to take away from this blog post are:

  • Be honest with your patients.
  • Never back yourself into a corner by giving your patient a definitive answer.
  • Make sure your level of knowledge make your confident as an autonomous practitioner.
  • Never guess.

This is a large topic to cover in one post, and I hope you may find it insightful. I have done my best to cover as many areas as possible with the words I have. If you have reached this far, thank you for taking the time to read this blog, hopefully the first of many to come. 


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