Doctor Parlays Skills Into Radio Network on Health

When it came to keeping his patients fully informed about their health, Dr. Nelson Kraus used a method of communication that might have made some physicians bristle.

“I used to sit down at a round table beside the patient,” Kraus said. “I’d put a tape recorder in the middle of that table, put in a 60-minute cassette and we’d talk. Then I’d give the tape to the patients so they could take it home and replay it.

“They loved it. They said they played it several times and each time they heard something they hadn’t heard before. And they played it with other family members.”

Kraus, a former family practitioner working in medical communication for the past 10 years, says other doctors may not agree with the way that he communicated with his patients.

“Some doctors would have said the first place the patient goes with that tape is to the lawyer,” he said, but noted that such openness between patient and doctor could cut down on the malpractice suits.

“The more information the patient gets, the more involved the patient gets with the care, the less likely the patient is to sue,” he said. “The doctor becomes a partner, but the doctor is not responsible. The patient is responsible for his own health.”

Kraus parlayed his communicating skills into the Health News Network, a series of health vignettes that air on 31 radio stations in four states and a Columbus television station, but he acknowledged that there are difficulties on both sides for that communication.

“Patients are intimidated by a person who knows a lot of things they don’t,” he said. “There is a fear on the part of the patient that if he becomes angry or upset, the quality of care may go down.”

Doctors are busy, often seeing as many as 85 sick people a day, he said. By the nature of their training, some doctors can be egocentric and arrogant, and some don’t know how to communicate.

“They know how to ask questions, they know how to interrupt answers, and they know how to give orders,” he said.

But he’s a firm believer that the patient needs to be the aggressor when it comes to talking with the doctor.

“There’s a difference between talking to and talking with,” he said. “Talking with means the doctor has to do a lot of listening.”

He suggests that the patient try and talk to the doctor on an equal basis.

“Here’s someone with a high school education or less, looking at someone who is speaking a foreign language to him,” he said.

To complicate matters is the dynamics of the situation. The patient usually is sitting on an examining table, wearing a flimsy gown and shivering. The doctor, wearing a white coat, is standing there holding the patient’s records.

Kraus suggests that the doctor and patient try to talk when the patient is fully clothed and that the doctor not sit behind a desk.

“The patient should position himself between the door and the doctor,” he said. “The doctor would have to go over, under, around and through the patient to get out of the office.”

He also suggests that the patient jot down questions between visits and have that paper in hand when facing the doctor. The patient should also write down things that the doctor says in the office.

“One reason patients don’t hear or retain is that they are nervous and they are scared of what they don’t want to hear,” Kraus said.