Member Stories

"Inviting Emotional Expression During Office Visits" by Jeffrey Millstein, MD, Penn Medicine

Friday, April 24, 2020

The volume of calls from patients worried about respiratory symptoms or possible coronavirus exposure continues to ramp up. Around this time of year, we are used to managing a lot of respiratory complaints, with the focus on flu vaccination and deciding who really needs antibiotics versus symptomatic treatment. Most of the angst I am used to hearing from patients with URIs stems from a desire to feel better as quickly as possible and return to productive life. Another emotion has now entered the picture which I am not used to in this context – fear. When Lisa (not her real name) called me this past week with sinus congestion after a trip to visit family in central Pennsylvania, her voice was a bit shaky, like she was holding back tears. She began her message as many have in recent days, “I know you must be getting a million calls about the coronavirus, but…”, and went on to tell me how she was feeling. I was impressed by her consideration, and reminded that I needed to do more than give clear information and guidance. Lisa needed my presence as she expressed her fear and anxiety about this terrifying viral menace in our midst.

The COVID-19 pandemic has forced anxiety onto center stage. It now belongs on everyone’s problem list. Whether it is mentioned by the patient or not, it is there and I am finding that patients are grateful when it is acknowledged. As such, I have been making it a habit to call it out during every encounter. Phrases like, “Tell me how you are managing your stress,” or “Would you like to talk about your fears or concerns about the coronavirus” have been very helpful at drawing out feelings during telemedicine visits. As with Lisa, some of my patients assume that I am too busy to address these issues, yet a brief chat about stress, anxiety or other pandemic related emotional reaction may be what they are truly seeking, more so than attention to their “chief complaint.” Giving patients space to express these feelings during routine or problem visits may be one of the most important parts of doctoring during these uncertain times.

Dr. Millstein is an internist, writer and educator, and serves as Associate Medical Director for Patient Experience at Regional Physicians of Penn Medicine.

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