Transcript The Patient-Doctor Relationship

The Patient-Doctor
Relationship
Sonia Sehgal, M.D.
Course Director CFI
Associate Clinical Professor
Department of Internal Medicine
UC Irvine Program in Geriatrics
This work was supported by a grant
From the Donald W. Reynolds Foundation
Objectives
• Understand why patient-doctor
communication is key to a
successful relationship
• Learn basic communication
strategies for an improved
patient-doctor experience
The Patient-Doctor
Relationship
• Class exercise:
– Tell me about your most
memorable positive experience
with a physician (when you were a
patient)
The Patient-Doctor
Relationship
• Class exercise:
– Tell me your most negative
experience
The Patient-Doctor
Relationship
• What does being a doctor mean
to you?
Communication
• Patient-Doctor communication is
important
– Improved satisfaction
– Improved compliance
– Improved decision making
– Better health outcomes
– Decreased malpractice claims
Communication Skills
• Essential for diagnosing and
treating illness
• Essential in establishing a
meaningful patient-doctor
relationship
• Facilitates educating and
counseling patients
Communication
• Information gathered must be:
– Objective
– Accurate
– Precise
A model patientdoctor relationship
• Trust
• Compassion
• Open and honest
communication
• Respect
Why is Doctor-Patient
Communication
Unique?
• Trust
– Patients on the first visit share
their most personal information to
someone they have never met
before
– They look to you for guidance
when making critical health care
decisions
Why is Doctor-Patient
Communication
Unique?
• Trust
– Within minutes of meeting,
patients are often required to
disrobe for a physical examination
and are placed in a vulnerable
situation
Communication
• Who will you be communicating
with?
– Patients
– Families
– Colleagues
– Other health professionals
Patient
Communication
• Patients who feel at ease are
more likely to tell you their
reason for coming to the
doctor’s office
• Be yourself!
• Show true interest
The Physician’s
Duties
• Respects the patient
• Ensures privacy and trust of
confidential information
• Demonstrates genuine concern
for patient’s health
• Limits distraction to provide
patient undivided attention
Respect
• Introduce yourself
– Patient
– Family
– Caregiver
Respect
• Explain your role and goal for
the interaction
Respect
• If appropriate shake hands
• Always address the patient as:
Mr., Mrs., Ms, etc.
Empathy
• To understand a person’s
experience
• Different than sympathy
• Requires
– Active listening
– Interest in patient’s experience
Objectivity
• Removing your own beliefs and
values
• Avoid judgmental attitudes
– IV Drug Abuse
– Education
– Socioeconomic status
– Language/Cultural differences
– Ageism
Active Listening Skills
• Respect the patient as a whole
person, not a diseased body
• Use confirmatory statements:
– “Yes”
– “Tell me more about that”
• Allow the person to tell their
whole story without unnecessary
interruptions
Active Listening
• Don’t be afraid of silence
Body Language
•
•
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•
Examination room configuration
Sitting/Standing
Eye level
Eye contact
– Note taking
• Posture
• Hurried speech
Body Language
• Patients notice more than you
think
– 2/3 of communication is nonverbal
• Appropriate use of touch
Patient-Doctor
Communication:
Key Points
• Ask about expectations, feelings
and concerns
• Show concern for comfort and
modesty
• Give an opportunity to express
feelings and concerns
• Encourage patients to ask
questions
Communication skills
can be developed with
practice, patience and
a willingness to learn