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Rogerian Letter

Gabrielle Hernandez
Louisiana State University

Authors note: This Rogerian Letter was written in ENGL 2001 for Professor Coco. This
paper addresses issues raised in the case study The First Three Minutes, published in Health
Communications in Practice: A Case Study Approach.
310 LSU Student Dr.
Baton Rouge, La, 70803

Phone: (504)-723-2247

April 23, 2017

Mr. Pat Smith


1325 Oakwood Dr.
Oklahoma City, Oklahoma, 73008

Dear Mr. Smith:

As a patients rights advocate, it is my duty to ensure that all patients receive the help and service
they deserve. I am glad to have stumbled upon your particular case study because health
communication is an issue that cannot seem to resolve itself. Communication between the health
provider and the patient is not always smoothly going, but it is the most important step in
receiving the help that you deserve. Your case is very similar to others, within the fact that the
doctor is usually rushing out the door so conversations are cut short. Those conversations are the
base of getting what is need from your health care provider. Coming across your case study,
which embeds the actual conversation between you and Dr. Jones, made me dig deeper to find
solutions to better these overseen issues.

Going back to the conversation between you and Dr. Jones, it is clear that there were major
communication issues. He repeatedly cut you off in the middle of your sentences. In addition, he
asked you multiple close-ended questions, maybe trying to pinpoint solutions. You were not able
to fully explain the back pain you had as well as you needed to because of this. Even though you
werent being heard completely, you did make attempts to speak. You tried telling him the pain
had spread and about the aspirin you were taking. Travaline states that,Such premature
redirection can lead to late-arising concerns and missed opportunities to gather important data
(2005). As a patient, you played your role by telling Dr. Jones extra information that mightve
been beneficial to know. Also, you answered all questions he asked you completely. You gave
him the respect that he didnt give to you. I assume that you must have felt neglected, as a person
and as a patient. He was overriding everything you were saying, and you didnt bother to repeat
yourself or go back to anything he missed. Mr. Smith, it is not your job to. As a patient, you go
to a medical facility to receive service you need. You shouldnt have to correct a doctor in his
mistakes. After all, it is the doctors job to give you the help you need. If the doctor isnt playing
his role correct, does that mean should you have to suffer for his actions? Another assumption I
made is that maybe you were a bit timid to communicate with Dr. Jones. The white coats doctors
wear present an authority in a sense. Eight plus years of college can really intimidate people.
Perhaps you followed the conversation as Dr. Jones led it because you have this perception that
doctors are all-knowing, so you would expect that they would know what they are talking
about. I would completely understand if this was your train of thought. I want you to know
youre not alone. Plenty of others think the same as you, including myself.

I have been in many health care facilities throughout my life, from being a patient to actually
observing communication throughout these places. Like I mentioned earlier Mr. Smith, you are
not alone. Many patients around the globe have encountered the same issue as you and feel the
same as you do. I can tell you from personal experiences that I have been in your position before.
When I was about fifteen or sixteen, I had this annoying cold for about a month. I went to the
doctor about three times during this incident. What I noticed throughout my visits is that the
doctors do most of the talking. What about us, the patients? When do we voice our problems?
Given the run-around and several different medications, the source of my cold was my allergies.
Allergies. Maybe if we had the chance to speak more, these problems wouldnt occur. Doctors
examine you, check your history, and ask multiple questions, which of most the answers are only
yes or no. You can try to explain yourself, but everything seems to revolve around the doctor.
The doctor who actually isnt receiving any help. These white coats they wear tend to give off an
illusion that snatches our attention. It is an actual theory called the White Coat Effect. When
doctors walk in with their flashy, white coats, it gives them an authoritative image. These white
coats are up for debate, saying that theyre a threat to patients, and that dressing differently
would create a more equal relationship rather than a paternalistic one (Brase, 2004). Patients
seemed to be blinded by this, even myself. I have never spoke back to a doctor, or even make
myself feel authoritative in an appointment, so I definitely understand your actions. It is hard to
communicate with someone so full of knowledge without feeling like you are in the wrong or
feeling belittled. Doctors may be an authority figure in a hospital, but they shouldnt be one over
our health. If these lagging issues in health communication continue, patients will never receive
the proper service they need.

After reading your case study and analyzing patient health care in general, I noted that doctors
neglect patients in a way. They do most of the talking. They speak quickly. They do ask close-
ended questions. However, Mr. Smith, I want you to realize that they are just trying to do their
job as quickly, yet effectively as possible. Doctors dont have much time to spend with each and
every patient. They are on a timely schedule. They have plenty of other patients that still has to
be seen. Maybe, in your case, Dr. Jones had many more patients that needed to be helped. Im
not saying the way he serviced you was proper, but perhaps he was trying to get as much
information out of you as possible. He was cutting you off because he didnt have the time to.
Back in the day, doctors were able to spend more time with patients. Now times have changed,
and they do have to rush, which has obviously created issues in health communication. I want
you to know that your health is the main focus of these appointments. The little time you do have
with Dr. Jones or any health care provider is extremely important. If the doctor is cutting you off
and neglecting you, that is where patients have to play a separate role. You have to tell the doctor
your health issues, but you also have to be authoritative if necessary. In your case, Mr. Smith, I
think it is necessary. Its not your job, nor should it be, but you have to out your foot down in a
sense. I say this with no offense, but as a patient it is your job to receive the help you need. The
doctor is not the one who needs the service. It is the patients. It is you. It is me. I understand that
this may seem a bit extra, but I hope you will see why it is so important for your voice to be
heard. Patients pay money to receive help and probably more money to pay for any medications
given. We shouldnt let our money go to waste. If we dont get proper service, it is our job to
demand it. If doctors keep belittling patients, will this common issue ever get solved?

After coming across your case study, I was able to closely examine communication between
health care provider and patients. Like I mentioned before, Mr. Smith, this issue occurs on the
regular. It is a serious problem that has been around. I understand how intimidating doctors can
be and how we have a natural urge to obey them in a sense. On the other hand, this cycle needs
to be broken. Doctors cannot be authoritative over our health, our body. We need to be
authoritative figures in appointments. It is a tough concept to grasp, but it is necessary
sometimes. If we keep letting them control us, things will get worse. Miscommunication can
actually hurt our health instead of help it. As society thinks, the doctors always right.
However, this is not true. There has to be a change come about, and it starts with us, the patients.
If we keep letting them override us, patients will never get the health care they truly deserve. I
hope you take my options into consideration next time you make an appointment.

Sincerely,

Gabrielle Hernandez
Patients Rights Advocate
Gherna9@lsu.edu
References
Cegala, Donald. (2005). The First Three Minutes. Health Communication in Practice: A
Case Study Approach (pp 3-10). New Jersey: Lawrence Erlbaum Associates, Inc.

Hughes, Clint. (2015). Five Ways to Improve Patient Communications. MediGain


Practice Management. Retrieved from http://www.medigain.com/blog/five-ways-to-
improve-patient-communications.

This article discussed several different ways to improve patient-physician


communication. It provides five different ways that physicians can communicate
more effectively: ask open-ended questions, assess potential barriers, pay
attention to nonverbal clues, use the teach-back method, and using a method
called Ask Me Three. This article shows the effectiveness of good communication
for the patients health.

This article entry is from an online periodical called MediGain Practice


Management. I would say that it is very credible. There is a spot on the website
for client log-in. I assume that on this website patients can create an account and
find general medical information that would be useful to them.

I used this source to discover more ways that would help patient-physician
communication. It also showed me what the doctor was doing wrong. It was
useful for contrast.

Gary Brase & Jillian Richmond. (2004). The White Coat Effect: Physician Attire and
Perceived Authority, Friendliness, and Attraction. Journal of Applied Social Psychology.
Retrieved from https://www.k-state.edu/psych/research/documents/2004JASP_000.pdf.

This article explained the controversy over doctors white coats. It explained this
white coat effect that has an impact on patients. The image of the white coat
creates inequality between them, which makes communicating even harder.

The article is from a psychology journal. The fact that its from a psychology
journal made it more credible to me. This white coat effect is something that
happens in our mind. It states how our blood pressure goes up and our heart rate
increases. Having this source makes patients reactions more understandable.
This source was useful to explain the white coat effect. It not only addressed the
mental effects of the attire, but the physical effect, authoritative effect, and an
attractive effect.

Travaline, J. M., Ruchinskas, R., DAlonzo, G. E. (2005).Patient-Physician


Communication: Why and How. The Journal of the American Osteopathetic Association.
Vol. 105, Retrieved from http://jaoa.org/article.aspx?articleid=2093086.

This article shows the importance of communication. It even explains how to


communicate with patients. It gives tips for physicians: slow down, be
empathetic, slow down, keep conversation simple, etc. This article was very
helpful due to all the tips mentioned. Its made for physicians and patients
perspectives.

This source is extremely credible due to the fact that the authors are doctors and
psychologists themselves. Plus there were 40 sources cited which shows how
much they dug down to find this information. In addition, the journal the article is
from is also medical field related.

This source introduced me to see both perspectives on communication. Since in


my paper I had to explain both sides, this was extremely helpful. It helped make
my paper unbiased and objective.