Dr. Jacobs Sands explains how he builds trust with patients by meeting them where they are, acknowledging fears, correcting misconceptions, and communicating with clarity and honesty.
He shares practical strategies for addressing stigma around cancer treatment, reducing fear of side effects, helping patients feel heard, and fostering a safe environment where questions are encouraged.
Transcript
Dr. Jacobs Sands:
So the patient is the reason that we’re doing all of this. So, I mean, of course, that’s important, I think just to face some of the challenges for patients. Often, patients come into the office not really knowing what to think or just being very scared about what’s going on. They have a cancer diagnosis, which in itself often for patients means death. And they’re talking about treatments, which often for patients means loss of quality of life. I will often acknowledge that for patients from the get-go, when I have patients who are appearing nervous or they’re kind of not sure or they’re particularly worried about side effects.
I will often say to them, hey, a lot of patients that come in, they think that with the cancer diagnosis, that means that they’re just going to die from it. And when they’re talking about treatment, they think that that means that they’re going to be laid up in bed, vomiting without hair, and oftentimes just to call that out, especially for people who have been thinking that they go, well, isn’t it? And to then be able to address that and say, well, thankfully, I don’t expect you to have vomiting or let alone even nausea most of the time.
The treatments are well-tolerated. Some of the biggest advances we had in cancer treatment 15 to 20 years ago was actually helping to reduce nausea. And I think by framing it that way, often patients hear that more than just if I went through the side effects with them from the get-go, but to try and kind of gauge actually where they’re at and engage with them where they’re at in a way that they’ll then be able to hear what is it that they believe that is not quite true. Now, believing that they’re going to have nausea is not in itself false necessarily, but there’s real context to that. Whereas, it is unlikely that it’s going to happen in the way that they expect, but it could happen. And so I’ll often try to really engage patients where they are by getting a sense of that first and then talking about what I expect. I also try to then give them a sense of likelihood. And I try to be very, very direct about all of this as much as I can. Anything that I want to communicate with them, I try to communicate as directly as possible.
And I think through this, engaging with them where they are, answering any questions that they have very directly, speaking in a way that is very direct. I try to make sure patients don’t ever feel like they need to be reading facial expressions or anything like that, or trying to understand what I’m not saying. I tell them, I don’t want you ever searching. I will tell you everything I think about this, but I’ll do it all within a sense of context and likelihood and such that through all of that it engenders trust. And so patients then are increasingly trusting of what I am telling them. And I want to make sure that we have developed that trust.
If I don’t know something, then I’ll tell them that I don’t know or why, or we can look it up to get that information. On top of that, when patients say that something is really important, I remember that. And I really make sure that we’re engaging around that thing that’s important to them, to make sure that we’re touching base, that this is happening in the way that they want. Now, part of this is really encouraging patients to speak up, too, is letting them know, I want to know when something is going on, when you speak up.
I appreciate that because it helps me to actually engage around what’s meaningful to you as well, or it helps me address something that you’re experiencing as well, and that’s really important to me. And I make sure they know that I care about how they’re doing so that they do speak up.