Scott Webb (Host): This is Putting Your HealthFirst. I'm Scott Webb. And today, I'm joined by Dr. Yaphet Tilahun. He's a double board-certified surgeon and colon and rectal surgeon with HealthFirst. And on today's video podcast, we'll get to know Dr. Tilahun and learn about his approach to patient care. Doctor, welcome to the podcast.

Yaphet Tilahun, MD: Thank you for having me.

Host: We're going to get to know you a little bit, so maybe you could walk us through your journey, if you will, into colon and rectal surgery, what drew you to this specialty, and what experiences shaped your approach as a surgeon?

Yaphet Tilahun, MD: The biggest thing that sort of drew me towards colorectal surgery was my affinity towards taking care of cancer patients. And so when I was finishing my general surgery residency and I was looking at into different fellowships, I was kind of torn between if I wanted to do surgical oncology versus colorectal surgery. And I kept gravitating towards colorectal surgery for a couple of reasons.

One was it had a very interesting approach in that there were a lot of the push was for minimally invasive surgeries, so laparoscopic surgery, robotic surgery. There was, you know, a level of consciousness towards not only the patient outcomes from cancer surgery, but also from how well you recover, you know, getting you back on your feet and back to normal activity was very important.

And so, I kind of deviated, and I also liked the non-cancerous work that colorectal surgery also encompasses, and sort of it's a very nice balance of things that are life-threatening, but also could be quite a nuisance and quality-of-life type of issues that we can help and improve people's lives. And so, it's a nice balance, and I think that's the part that I like the most.

And it's a unique field in that, you know, you take care of people in moments where they feel at their lowest, but then you also get to build relationships and continue that relationship over a long period of time, which is not always very common in most surgical subspecialties. So, I like that component of it., And so, that's how I ended up in choosing colorectal surgery versus, for example, surgical oncology.

Host: Yeah. It sounds like you really do develop a rapport and a relationship, so to speak, with patients. And, Doctor, I know when they come to you, they're often dealing with sensitive or uncomfortable issues, right? So, how do you approach building trust and making them feel at ease during their care?

Yaphet Tilahun, MD: I mean, most of the time, it depends on the issue, right? So, I think majority of the time, if it's for serious issues such as cancer, most of those approaches tend to be by building up the confidence. I mean, they need to know that they trust my knowledge base and my judgment as well.

And so, I spend a lot of time for complex patients such as cancer patients, where we go over everything we know. If there's information we don't know, why it's important to sort of investigate those things and know them. And then, you know, making myself as available as possible so that they know that they have someone they can reach out to, and that we're going to build a proper team around their cancer care as we go forward.

Cancer-related care has to be very centered on making sure that you're building the confidence that the patients have. Now, you still have to do it on other cases such as hemorrhoids, fissures, and things like that. But it's different when you're walking into someone where they have more of an anorectal concern, right? So when you walk in there, there's a lot of embarrassment. People don't really want to talk to me, especially as a guy, if it's mostly women. And guys are usually not excited to talk about their bums most of the time as well. So, those I tend to approach with a little bit of humor. I try and diffuse a lot of the tension depending on, you know, you walk in, and you try and gauge maybe what would work with the individual in the room. But just make them feel heard, make them feel like this is not something unique to them. That is very common, and that is normal to have these conversations.

Most of the time, by the end of me meeting someone, we've talked about things they've never talked to anyone about. And in that sense, it's a huge privilege to be able to allow people that space where they feel comfortable enough to share. But the goal is to get them back to a place where they're not worrying about this constantly, right? So to reassure them whatever they worry about, and also find a solution that resolves whatever it is that led them to come to my office.

Host: Yeah. It makes sense to me. I'm just thinking about the types of patients that you see, men, women, you know, and nobody really wants to have these conversations, right? You may be the only one in the room who really sort of wants to have this conversation because you have to, right? Because you're the expert. I just want to get a sense. You gave us an idea of how you got where you are. Wondering how all of that sort of influenced the way you connect with patients as you're discussing and just your approach to care in general.

Yaphet Tilahun, MD: I will say, or like, for example, going through medical school, it's very, very formal. There is a level of the way the education is done where it doesn't feel like you can be yourself, you can use humor, you can kind of take away a lot of the tension in the room in certain situations.

And the first time I ever experienced that in medicine was when I was shadowing a colorectal surgeon, and you can feel how different individuals were so nervous, you know, And at the time, you know, as a trainee, it's myself, the attending, the other residents, and the fellows. And you have four or five people in the room and you're having to talk about your bum, and it's just so nerve-wracking to have those many people in there.

But in a unique way, a lot of the attendings that I worked under had a wonderful way of diffusing that tension with jokes or pointing out how just uncomfortably awkward this is. And it just takes away a lot of that tension. And I think they don't outwardly teach you these things, but I think it sort of self-selects for the people who naturally have that ability to do that tend to go into colorectal surgery. It makes it so that like you need to have a level of humor and ability to sort of take away that tension in a room. Is that something taught or is that something that just naturally happens with most of us in colorectal surgery? I would probably say most of us tend to be that way at baseline anyways, and you kinda just find a niche that fits your personality and you feel more comfortable dealing with.

Host: Maybe just give us a sense of your kind of personal philosophy, you know, when it comes to caring for patients. What makes you you, I guess?

Yaphet Tilahun, MD: I think for me the most important thing is making sure everybody feels heard and seen. I don't want anyone to walk away where they feel rushed and their concerns were not addressed. And so, I think my goal a lot of times, you know, I'll run late in the office because I will spend an extra 20, 30 minutes with someone if they need it.

Because I find that over the years and including with my own family members, people feel always rushed when they're with the doctor, that they never feel like they have the time to really express how they feel. And so, sometimes, you know, you have 30 minutes to see someone, but if it means I give that person an extra 15 to 30 minutes to allow them to sort of be able to be fully heard, I think it's overall very worth it because we get to the right solution and we're not just sort of like continuing a pattern of care that potentially may have just prolonged their suffering.

So for me, it's about making sure patients feel heard, that we get them the right type of care in a way that benefits them. And sometimes it ends up being, you know, it's not me who takes care of them, but just being able to have that conversation helps us figure out, okay, where's the right place for you to be able to get the care that you really need to find the solution.

Host: Yeah. You know, we're all patients. You're a patient. I'm a patient. And I try to remind myself I have the benefit of hosting these, and I try to remind myself when I'm there waiting for my doctor and she's running a little bit late, that means the person she's with is getting an extra five, an extra 10. And I know how that makes me feel when I don't feel rushed, when I feel really seen and heard. And it sounds like that's kind of what you bring to the room as well.

Yaphet Tilahun, MD: Yeah. And, you know, I think it's like my wife always reminds me, you know, I have three kids at home, and for her to make it to a doctor's appointment is such a struggle, right? Because by the time you get three kids ready, try and get them out the house, and I still remember to this day, one of my medical assistants one time she said to me, "Hey, Doctor, this patient is thirty minutes late. You still want to see her?" And I was like, "Of course, I'll see her." It's like, you know, maybe she had to run back in the house because, you know, she had trouble with the kids. And she kind of was like, "Oh, God. We're going to run even later in the office." And it's like, I said, "It's okay. We'll figure it out. Just bring her in."

So, she brings her in the room and rooms her and comes up to me and she goes, "How did you know?" And I was like, "What do you mean, how did I know?" She goes, one of her kids had an accident, and she had to go back in and change the diaper. That's why she's late. And I was like, "Yeah, because life happens to everybody, right?" So, you know, her being five minutes late, 10 minutes, 30 minutes late, you know, to ask her to reschedule is such a hassle because she's probably been waiting for this appointment for over a month. And it's not fair, it's not right. You know, I have to respect her time and my patient's time that they've put in to come see me. So, them being late doesn't bother me either, you know?

And so, those little things I think is important in terms of, you know, the same way, you know, a lot of times sometimes patients are upset I'm running late. But as they get to know me, they realize if I'm late is because, like you just said, giving someone else the time that they needed. But at the same time, if they're running late, I will accommodate them as well. And so, it's a two-way street because life happens to all of us, and we can't control everything.

Host: Yeah, that's for sure. Life happens, and as you said earlier, we don't really want to think about this stuff. We don't really want to talk about this stuff. You know, that's the goal for today. Appreciate your time, expertise, your compassion, all of it. Thank you so much.

Yaphet Tilahun, MD: Welcome. Thanks, Scott. This was wonderful. Appreciate it.

Host: And to our listeners, if you have a concern or would like to schedule an appointment with Dr. Tilahun or a primary care provider, visit hf.org/findadoc. And if you enjoyed this episode, please share on your social channels and check out the entire podcast library for topics of interest to you. This has been Putting Your HealthFirst. Thanks for watching.