Helping Our Patients Achieve RWB

How can we as health care providers help all our patients achieve reproductive well-being?

by Raegan McDonald-Mosley, MD, MPH

published 01/12/22

I’m a gynecologist, and I spend much of my working life speaking to my patients about their bodies, their sex lives, and the rest of their lives as well. However, throughout my career, I have learned exactly how important it is to not just talk. I also listen. My ears are often far more valuable a tool in my provider’s toolkit than my lips.

As providers, and as physicians especially, we’re trained to talk at people a lot, which I often find to be the wrong approach. It’s something I have had to undo in my training because if I’m not asking questions and empowering the person in front of me to do most of the talking, I could be missing critical information about their life. I’m not an expert in that person’s experience, and I haven’t walked in their shoes, not one step. While I might know the science and literature about what happens when the average person takes a certain pill or what the average person’s vaginal discharge looks like, that doesn’t mean I know anything about whoever is sitting in front of me in the exam room.

Really, the most important thing is to motivate people and to get them talking about what’s going on in their lives. What type of sex are they having? Is it pleasurable for them? Are they in a healthy relationship with their partner? If not, do they want help and support doing something about it?

That can be challenging in my experience. The clinical environment can be intimidating for everyone—especially for young people—and it will likely take practice both on the provider and patient side to find the right balance between speaking and staying quiet. Even if it takes a number of conversations or visits for a patient to open up, I want all my patients to know that they have a safe, non-judgmental resource in me. We need to be comfortable asking challenging questions about what kind of sex people have, concerns about pleasure, gender identity, and more. Because if we are uncomfortable with those things when we enter the provider-patient interaction, our body language and reactions may alienate our patients. The best way for us to get better? Practice! Literally, practice! Practice with colleagues, practice with family, practice asking questions in a non-judgmental way.

In my experience, being non-judgmental goes hand-in-hand with asking questions. All people deserve to find a provider that’s affirming and non-judgmental, asks them all the right questions, and listens. It’s critically important that, as providers, we don’t make assumptions about the person in front of us. We can only learn about a person by asking them questions and listening to their answers. As someone who loves to talk, it’s something I know I need to be deliberate about to be a more effective provider.

We must also recognize that bias is real, and we all have it—no matter our gender, sexuality, race, or religion—it’s just a part of being a human being, and it’s how our brains function. We must do the work to understand our biases, how they can impact our patient interactions and try and overcome them. We shouldn’t provide different care to people based on their income, their insurance status, or what language they speak. One of the tools I love is One Key Question ® because we ask everyone about their reproductive plans and desires. It’s been critically important to me in confronting my own biases and assumptions.

All providers must do the work and learn about what providing person-centered care looks like. By caring for the whole person, I know that I’m giving my patients the best care I can provide. I am also helping the people I see feel that I’m caring for them more fully and not just objectifying them as patients or people who need birth control.

As providers, by giving the same attention and care to improving our people skills as we do our clinical knowledge, we can ensure that every patient we interact with walks away with a sense of being heard, seen, and cared about. Continuing to better the care that we provide our patients is crucial for making sure that everyone has the power to decide their future.

read more about:One Key Question,Reproductive Well-Being,shoptalk
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