The Worry Debrief

Based on a real patient scenario. Details have been altered to protect confidentiality

What past situation are you worried about and why?

I’m worried about D - I don’t think she really liked my answers to her questions. She seemed mad and dissatisfied when I left. I’m worried she thinks I’m an incompetent clinician because I forgot the dose of that medication and had to look it up in front of her. After all the time I spent with her in the room, she still asked to see a specialist at the end of the encounter, so she definitely didn’t respect my assessment.

What emotions are still sticking with you about this situation? 

Anxious, annoyed, flustered, embarrassed, shame

What were the bare bones facts of what happened in that situation?

D presented with X symptoms.

I asked her questions and did a physical exam. 

I told her my suspected diagnosis and what tests and treatments I wanted to order next.

I forgot the dose of the medication and looked it up.

D asked 5 more questions at the end of the visit, including to see a specialist for her symptoms.

What are your worries about what you did in that situation?

I’m worried I spent too much time with her

I’m worried I didn’t sound impressive or confident enough for her to believe me

I’m worried I missed something because I was annoyed at all of her questions

I’m worried that she figured out I don’t know what I’m doing because I didn’t have all the answers for her questions.

What do you feel good about doing in that situation?  

I feel good about the questions I asked her on history.

I feel good about remembering which medication to prescribe, even if I did have to look up the dose.

I feel good about my diagnosis and plan.

I feel good about convincing her to at least wait to see what the test results show before referring to a specialist

What has this situation shown you about where you’re still learning to trust yourself?

I am still learning to trust my plan even when the patient isn’t on board.

I am still learning to trust that I am a good doctor even if I forget a fact or don’t have all the answers.

I am still learning to trust my ability to end an encounter on time, even if the patient doesn’t seem satisfied.

Your future wisest self has a message for you about this situation. What is it?

Hey Joan - I know this encounter felt really yucky to go through. It can be so embarrassing to fumble in front of someone, especially if that person is critical of you already! I want you to know that this one encounter does not reflect all the amazing work you’re doing for your patients, and all the ways you are helping them. Please don’t let this one wobbly moment define you. If a patient doesn’t see the value you can offer to their care - that’s THEIR issue, not yours my love. You did good work today, and you are a worthy person no matter what work you do.