patronizing your patients

Do I Infantilize My Patients?

infantilize /inˈfantilīz/ – verb – to treat (someone) as a child or in a way that denies their maturity in age or experience.

Infantalize is not a pleasant word.  It conjures condescension and patronization, neither of which does any clinical caregiver wish to be guilty. There can be a fine line between condescension and explaining in lay language. When I assume my patient must have something explained to them, am I being patronizing? 

It can be a matter of perspective. And tone has a lot to do with it. I have witnessed a number of hearing care providers who speak to adult patients in an altogether inappropriate sing-song, as if they are speaking to a child. 

No patient wants to be talked down to. Neither do they want decisions made for them that they are perfectly capable of making for themselves.  This is where infantilization comes in. I do not believe that hearing care providers deliberately infantilize their patients. But do we, by our actions and omissions, sometimes do just that?  

 

Helping or Patronizing?

 

As healthcare professionals, it is our job to make certain decisions for our patients.  This is only good professional practice and is part of our responsibility to our patients.  Sometimes these decisions go against our patients’ wishes – as when we resist the patient with the precipitous hearing loss’s desire to obtain CIC hearing aids. Or when the patient with atretic ears insists on being fit with RICs (it happened to me, folks!). 

To paraphrase an article from several years ago by Dennis Van Vliet, it does our patients no favors to allow them to drive when it comes to clinical matters. 

But when we make non-clinical decisions for our patients, we could certainly be guilty of infantilizing. This can occur when making a technology recommendation that does not line up with our patient’s lifestyle needs because we think they may not be able to afford it.  Or to assume from a patient’s attire or the appearance of their vehicle that a higher technology recommendation would be counter-productive.  All our patients deserve to be apprised of the optimal technological option appropriate for them.  Whether or not to follow that recommendation is a decision a responsible adult will wish to make for themselves.  

Infantilization can also occur when it comes to offering financing. I have seen many occasions where it is apparent that the biases, financial habits and proclivities of the provider inform the variety (or lack of variety) of financing options that are presented to their patients.

A well-meaning provider recently told me that she offers no other option than 12-months-same-as-cash because she does not want to add the burden of interest on top of the already high cost of the hearing aids.  Others have told me they don’t want their patient to be in the position of still paying for their hearing aids 3 years later when they may require new instruments.  The same goes for not extending financing options to patients who appear to be easily capable of paying for their hearing aids without financing.  Who am I to say they would not find financing options attractive by making the decision to purchase optimal technology easier?

 

Are we limiting options?

 

Whatever the reasons may be, or how well-intentioned the rationale for doing so, the fact is that by limiting the options we offer our patients, we take off the table choices that may be appealing to them.  We really are treating our patients as children, unable to make decisions for themselves. 

I know I do not want to be treated in that way.  Do you?

This brings to mind the experience of a former colleague who had fit a long-time patient with what was at the time mid-level technology.  Several weeks later the patient showed up without an appointment, mad as a hornet.  “I just had lunch with Sonia [another of my colleague’s patients] and she showed me her new hearing aids.  She told me they were top technology.  So what am I, chopped liver?  I don’t deserve top technology too?”  That cured my friend from making that error ever again.  

By presenting our patients with what we determine to be their optimal technology recommendation and with the full array of payment and financing options available to them, we treat them with the respect that they should expect from any healthcare professional.  

 

 

Paul U. Teie, MS, has been an audiologist since 1991.  He has spent much of his career in direct clinical care but has filled other roles in the hearing care industry as sales representative of a special instrument dealer and a hearing instrument manufacturer.  Since 2007 he has provided sales and clinical training for large hearing care networks and currently trains for HearUSA/HearCanada


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