Worried about coronavirus? Your doctor wants to listen. l Expert Opinion
It's stressful to deal with family and friends who don't take the pandemic as seriously as you do. Consider it as worthy of a health discussion as any other major problem.
It was toward the end of his office visit when I asked my patient, a 60-year-old man with asthma and coronary heart disease, how he was managing with the constraints of life during COVID-19. Early in the pandemic, it was usually the first thing to come up in conversation with the patients I saw through telemedicine, but now it seems that many of my patients keep their COVID feelings inward.
“Well, I was doing well until I got an invitation from some family who don’t seem to think the virus is still a problem,” he replied.
He went on to describe his dilemma: His daughter was hosting her child’s 4th birthday party inside her modest home, with 20 guests. When my patient questioned her wisdom, his daughter replied, “It’s just family — nothing to worry about.” He tried to express his concerns about social distancing, which were quickly dismissed with disdain. The conversation did not go well, and family tension persisted. This conflict was having a profound effect on my patient’s emotional health, yet he did not intend to bring it up without my prompting.
How many similar scenarios remain unprocessed, causing stress or even depression, and fracturing relationships? I fear that there are many.
There are numerous reasons why people may now choose to guard their feelings about the pandemic. Some may feel that their opinions have come to represent a political affiliation which they prefer not to disclose. Others may worry that I will not listen to their perspective, if they are beginning to doubt some of the COVID medical guidelines. The pandemic has worn on for months, and many people are just feeling exhausted with the topic and less inclined to bring it up, even if they have questions or concerns. I have discovered that, in contrast to earlier pandemic days, I must often initiate the COVID conversation. The gravity of issues raised always makes me glad that I did.
I view this, as do many of my colleagues, as a call to action, on behalf of individual patients, and for the public health. My patient and I had a constructive discussion about his family party, and how he might manage his personal risk. If family tension continues to rise, a counseling referral may give him some tools to engage in a more productive, nonconfrontational discussion with his daughter. In this case, my patient’s concerns were medically sound and easy to empathize with.
It is just as important, though, to allow the less well-informed to sound off. As with other patients who are reluctant to follow guidelines, using stories to illustrate the risks of poor decision making can be very powerful without sounding judgmental. When I am able to frame these discussions as supportive, and am clear that I intend to listen and not lecture, patients raise many issues which may have otherwise continued to fester, resulting in poor outcomes and deeper personal conflict.
I encourage all you patients to view your care provider as a resource for all COVID-related matters, regardless of your feelings about the pandemic and how it has been managed by local and national leaders. As the months of pandemic restrictions persist, available information has become more challenging to process, and patience has worn thin. Issues raised have become more nuanced and personal. Beyond providing factual information, clinicians are there — as always — to listen to you, and help you find your way.
Jeffrey Millstein is a primary care physician and medical director for patient experience-regional practices at Penn Medicine.