Excellent Primary Care - Pillar #2

Today, let's dive into Pillar #2 - Being understanding, even when we don’t fully understand.

When we feel care and responsibility for our patients lives - but we find them making decisions that we can’t understand - the protective instinct is often to judge. But judgment keeps us far away, and we are only effective guides when we stay close. The moments in which we can’t connect the dots, when we can’t quite grasp why a patient behaves in a particular way, when we can't understand - are the most important moments to remain understanding.

Being understanding doesn't require actually understanding; often times, it won’t. All of the cultural competence modules in the world (while certainly helpful!) can't prepare us for the diversity of human experience, and for the special, difficult role that we play in navigating through ambiguity.

Ex: A frail patient who denied alcohol use on our intake ends up admitted to the hospital after a fall with a positive EtOH level. This is a challenging moment! While transparency is key to a successful relationship, it's naive to deny that patients have many sound reasons to distrust the health care system. There’s no easy answer here, but this is a common moment where we create distance. And it may be the most important moment to demonstrate our consistent presence.