Anxiety

Anxiety is a huge issue. It doesn’t just affect the many people who experience Generalised Anxiety Disorder and other formal diagnoses containing components of anxiety, it affects all of us.

Sometimes life contains more anxiety than at other times, but there will usually  be some form of anxiety linked in to a visit to a doctor.

All kinds of anxieties can abound when visiting a doctor.

Will the doctor be running on time? When I see them will I be able to properly explain what it is I am seeing them about? Will I forget to say or ask something in the pressure of the moment? Will they take me seriously? Will they help with what I think I need or will they ignore what I want? Will they be able to find out what the problem is? Will they be able to make me better?

The list goes on and on…..

It’s well recognised that its important to consider a patient’s anxieties when they come to see a doctor. Repeatedly we were reminded as GP trainees to ask about Ideas, Concerns and Expextations (ICE).

Even if we are fantastic at eliciting these things, as we talk to our patients the even bigger challenge presents itself of how we help patients with these things. Expressing anxiety helps to some degree but how do we respond to these anxieties?

Disease and illness is a scary thing – it would be strange not to find it scary!

Anxiety is about the realm of the unknown, of what could change in the future. However, human value is unchanging. In helping our patients see their value is unchanging it will help deal with the anxiety relating to the uncertainties of their illness and disease.

If we have our patients’ trust because they can see we value then we will be in a much better position to help talk through their anxieties. We need to earn the trust of our patients as well as recognising the trust they heave already put in us by coming to see us.

We earn trust by showing we value patients, by giving well thought out clinical advice and by communicating to them we think they are valuable by the way we communicate with them. We can even tell our patients directly that we see them as valuable.

In the case in my first post, when I was listening to my patient his anxieties were expressed. However, I responded through becoming anxious myself and I wasn’t able to help him work through his own anxiety. When I looked to start again by making his value my focus, I was much more able to help him with the anxieties around his health.

Not just for some

This is not anything new and many doctors already approach patients in this way. However should this just be something for those who have a particular interest in mental health or those who are highly compassionate?

This is about good quality care, and maybe we could aim to work at this in the same way as we work to provide more measurable aspects of care? It is a huge challenge and we are already working hard. When we think about working at valuing patients, we often see the way to do this well is to give patients more time – which is certainly an excellent way of doing this. We need to keep looking at ways of finding more time. However our time is limited. We need to learn to communicate value not just with time but with how we approach our patients, having valuing patients at the core of how we approach each patient.