The PatientDoctor Relationship Sonia Sehgal M D Course

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 • • 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