Politics, Religion & Probing Questions: How to Handle the ‘Touchy Subjects’

How to Handle Touchy Subjects

Over the course of their careers, doctors are sure to encounter more than a few uncomfortable questions from patients or staff – and some matters aren’t all that easy to evade.

Despite the frequent occurrence of touchy subjects in the medical practice, ethical guidelines rarely dictate what routes docs should take when such sensitive stuff comes up. Preparation for the tough questions is often the best protection. Consider how you’d handle it if these taboo topics came up in your office.

Politics
With the recent Supreme Court ruling on healthcare reform still making headlines and presidential election campaigns in full swing, it may be hard to avoid the presence of political talk in your office. Nonetheless, it serves you well to keep it to a minimum.

In a recent CareerBuilder survey, 36 percent of workers said that they discuss politics at work, and 23 percent of that group said such discussion turned heated or into a fight – the last thing you want patients seeing in your practice.

You’re legally allowed to ban politically charged employee conversation. That may be too restrictive a policy to implement preemptively, but should hot-button talk get out of hand you can nip it in the bud simply by changing your office rules. You’re more limited, however, when it comes to patient discussion. What to do when a patient puts your politics on the spot?

Directness and common sense should guide your dialogue. An interested question asking your opinion on healthcare reform may be worthy of a chat; since it so directly impacts your profession, your thoughts on the ACA are akin to shop talk. But if you sense that a patient is bringing up election talk or other partisan issues in a way that’s argumentative or hostile, cut it off. Tell your patient that aggressive political debates are bad for his health and inappropriate for the healthcare setting.

Religion
In a 2007 piece from the Archives of Internal Medicine, 75% of physicians said patients sometimes or often mention spiritual issues such as God, prayer, meditation or the Bible.

Whether or not you experience that much of it in your practice may have to do with the policies of your organization, such as whether you’re owned by a Catholic hospital group or other religiously affiliated entity. Nonetheless, how to handle explicit questions about or acts of spirituality in your patient encounters is a decision you must make based on your comfort level.

If, for whatever reason, you’re uncomfortable partaking in expressions of faith in the medical setting, a cautious way to handle such situations is to respectfully decline to discuss your own religious preferences or any requests to lead a patient in prayer.

Some doctors establish a happy medium by refraining from engaging in shows of religion, instead standing respectfully by while patients do so in their presence.

“Being there silently with the patient during the prayer is, for the most part, a benign demonstration of validating the patient’s faith as being important to them,” Dr. G. Richard Holt, professor emeritus in the Dept. of Otolaryngology at the University of Texas Health Science Center at San Antonio, told amednews. “It does no harm to the doctor or the patient and usually does good. To me, once you start taking an active part in it, I’m concerned that it becomes different.”

Your Personal Life
While working for doctors and lawyers in my hometown, I observed the discomfort some of them experienced when patients or clients tried to discuss the concerns of their private lives – divorce, death in the family, legal or health troubles affecting their kin – in a public way.

And that doesn’t begin to scratch the surface of what personal information some patients may try to pry out of you. Some folks want a small-town-doctor experience from their physicians no matter where they live, and won’t be shy about digging up whatever they can about you.

Navigating that territory requires that you establish boundaries and stick to them. Keeping all of your business to yourself is no easy task, as it would likely necessitate that you opt not to care for any individuals you have a personal connection to: fellow congregants in your church, parents of your children’s schoolmates, or relatives of your friends. Maybe that type of strategy appeals to you, or maybe it feels limiting.

But choosing to keep your private life as private as possible doesn’t make you cold. Faced with a probing question about your ailing mother’s condition or why you and your husband are splitting up, straightforwardly inform your inquiring audience that you’re choosing not to discuss such matters in your work setting.

When appropriate, as in matters of condolence, thank your patient for expressing concern. With the nosy folks, get right back to the health issues that brought them to your office in the first place.

How have you worked through these kinds of situations with staff or patients?