Communication 101

Question 1

What is a common discrepancy regarding how doctors and patients view their communication?

Answer 1

High percent of Doctors tend to over estimate their ability to communicate
Low percent of Patients experience effective communication

Question 2

What are the benefits of communication?

Answer 2

Happier patients
Aids in diagnosis and treatment of disease
Improved clinical outcomes
Increase in career satisfaction

Question 3

According to patients, what are the 6 most important factors in choosing a physician? (Most important to least)

Answer 3

Bedside manner/communication
Board certification
Recommendation from family/friend
Location of office
Hospital affiliation
Where doctor was trained

Question 4

What do most patients judge based off of regarding bedside manner?

Answer 4

Quality of beside manner is an indicator of general competence

Question 5

What are 3 clinical outcomes that improve with adequate communication?

Answer 5

Case history
Compliance with treatment plan
Understanding of importance of management strategy

Question 6

According to the survey of 1500 PCPs what factor had the strongest effect on career satisfaction?

Answer 6

Quality of patient interactions

Question 7

According to Oxford what is the definition of communication?

Answer 7

The imparting or exchanging of information by speaking, writing, or using some other medium

Question 8

According to Cambridge what is the definition of communication?

Answer 8

The exchange of information and the expression of feeling that can result in understanding

Question 9

How can we achieve effective communication? (5)

Answer 9

Respect
Empathy and compassion
Trust
Practice
Patient-centered care

Question 10

What are 4 aspects that define a patient-centered practice?

Answer 10

Partnership to establish patient needs and desired outcomes
Patient feels in control
Shared decision making (custom management plan)
Not only from clinical perspective

Question 11

What aspects do we notice during a first impression? How long does it take to judge a person?

Answer 11

Voice pitch (higher=more trustworthy)
Eye contact (attentiveness, confidence)
Handshake (confidence)
Facial expression (trustworthy, likable)

1/10th second

Question 12

What is important to include in the initial introduction? Why is this important?

Answer 12

Use proper title (respect)
Smile
Handshake when appropriate
Apologize if late

Sets tone for exam

Question 13

As you walk to the exam room how is communication continued?

Answer 13

Walk next to patient
Initiate casual conversation

Question 14

How can communication be improved while taking a case history? What is the most important?

Answer 14

Sit at patient’s level
Eye contact
Determine reason patient is seeking care
Listening (MOST IMPORTANT)
Develop proper questions

Question 15

What is a closed question?

Answer 15

Yes and no questions
Elicit discreet information (short and definite)
Used in beginning to seek permission to ask questions
Ex: Is it all right if I ask you some questions?

Question 16

What is an open question?

Answer 16

No right or wrong answer
Gives patient control
Doctor listens, observes, and learns
Ex: What brings you in today?

Question 17

What are questions that probe?

Answer 17

Seek more info about a topic
Encourage details about info previously mentioned
Ex: Can you tell me more about the pain you’re experiencing?

Question 18

What can be a disadvantage of using questions that probe?

Answer 18

Over-use can be negative and seem interrogating

Question 19

What are questions that clarify? What can they help to avoid?

Answer 19

Seek understanding rather than info
Achieve misunderstanding, avoid misinterpretations
Ex: Do you mean the pain spread to your lower eyelid?

Question 20

What can occur if “questions that clarify” are overused?

Answer 20

May suggest that physician is not able to understand patient

Question 21

What are questions that lead?

Answer 21

Direct the response of the listener
Not patient centered, do not give patient control, may not provide honest answers
Ex: You didn’t miss your medication last night, did you?

Question 22

When are “questions that lead” best to avoid?

Answer 22

When goal is to seek a trusting, respectful patient-doctor relationship

Question 23

What sets the foundation for the exam?

Answer 23

Case history

Question 24

In what percentage of encounters did the physician interpret the patient’s opening statement?

Answer 24

70%

Question 25

What occurs when the physician interrupts the opening statement? Average time before physician interrupted?

Answer 25

Potential loss of relevant information
18 seconds (most opening statement were between <60 to 150 seconds)

Question 26

How has the interruption time during opening statements changed from 2018 to now?

Answer 26

Increased from 11 to 18 seconds

Question 27

Why is it important to listen to your patient?

Answer 27

Information for diagnosis
Therapeutic
Patient-doctor relationship
Time

Question 28

When is it appropriate to respectfully interrupt the patient?

Answer 28

Need to ensure we obtain full case history and understand concerns

Question 29

What two factors influence the decision to interrupt?

Answer 29

Respect for the patient
Quality of the relationship

Question 30

What is the triple E approach?

Answer 30

Excuse yourself
Empathize with interrupted topic
Explain why you interrupted

Question 31

What are the 3 basic components of case history?

Answer 31

Development of appropriate questions
Listening
Responding to negative emotions with empathy