|Encouraging Better Doctor-Patient Communication
According to Dr. Robert Johnson, the Director of Adolescent and Young Adult Medicine at University Hospital and New Jersey Medical School in Newark, New Jersey, the young men he sees are comfortable communicating with him about all areas of their lives. “I give them permission to talk about things that might otherwise make them feel uncomfortable,” he says. I can’t think of the last time the stereotype of the uncommunicative male was an issue in my office.”
In addition to his work at the Division of Adolescent and Young Adult Medicine, Dr. Johnson is a Professor of Pediatrics and Psychiatry at the University of Medicine and Dentistry of New Jersey. His previous positions include Attending at New York University Medical School and Director of Adolescent Medicine at Martland Hospital and St. Michael’s Medical Center, both in Newark. Dr. Johnson has been a member of the Board of Directors of PRCH since 1997.
In terms of doctor-patient communication, his advice to other physicians is simple: “Listen. Be direct and honest, take the time to sit down and establish communication, shake hands, sit down to take the history, don’t rush, use language that’s understandable, and talk about their lives beyond their immediate complaint.
“Human connection is really important. Doctors themselves have to be comfortable communicating. They shouldn’t hide behind big fancy words or professional detachment. That impedes healthcare,” says Dr. Johnson. Our job is to make people feel better, one way or the other. That might mean making them feel better not by shots or pills or surgery, but by a relationship, and people feeling good about that relationship.”
Dr. Johnson uses the direct approach, asking his patients whether they’re sexually active, and if so what forms of sexual activity and what risk behaviors they undertake. In that process he can recommend appropriate screening tests and advice about minimizing risk. “Doctors have an obligation, number one, to query teenagers about their sexual lives. They should not be judgmental to any teen, and be open to all teens and the questions that they may have. No category is absolutely taboo. In a lot of cases, I may be the only person the youngster has an opportunity to talk to. For example, I might be the only person told about sexual abuse. And that’s because I was the only one who asked. It’s important for a kid to have those outlets.”
Dr. Johnson admits that getting comfortable with talking about sex takes practice: “I have a tape recording of my first patient interview, and my voice cracked whenever I said ‘penis’ or ‘masturbation.’ As you become more comfortable, it becomes easier and natural. And the kids don’t mind talking about it as long as you give them permission.”
Since he deals primarily with adolescents, there are sensitive issues in terms of parental involvement. Dr. Johnson makes it clear with every parent that communications between the patient and him are confidential, especially when it comes to counseling: “That’s the only way it’s going to be effective.” However, there are times when he may breach this confidentiality; for example, if he thinks a patient is going to harm someone else or him or herself, or in cases of sexual abuse. “You get a feel for it as you go along and individualize it, depending on who the youngster is.”
The Division of Adolescent and Young Adult Medicine is comprised of 100 people who devote themselves to 17 programs, including the Young Fathers’ Program, which Dr. Johnson founded more than ten years ago. The Young Fathers’ Program addresses everything from education needs to job placement to emotional support of teen fathers.
Dr. Johnson has watched his patients become “doctors, lawyers, judges, gangsters, celebrities and homeless people.” Some of these patients continue to see Dr. Johnson for healthcare, and some of them bring their teenage sons to him now. The rewards of Dr. Johnson’s career become clear when his patients call just to see how he’s doing: “Over 25 years, I’ve realized that most of the good that I’m able to do is not related at all to the prescriptions I’m able to write.”