Communication 101 Flashcards
What is a common discrepancy regarding how doctors and patients view their communication?
High percent of Doctors tend to over estimate their ability to communicate
Low percent of Patients experience effective communication
What are the benefits of communication?
Happier patients
Aids in diagnosis and treatment of disease
Improved clinical outcomes
Increase in career satisfaction
According to patients, what are the 6 most important factors in choosing a physician? (Most important to least)
Bedside manner/communication
Board certification
Recommendation from family/friend
Location of office
Hospital affiliation
Where doctor was trained
What do most patients judge based off of regarding bedside manner?
Quality of beside manner is an indicator of general competence
What are 3 clinical outcomes that improve with adequate communication?
Case history
Compliance with treatment plan
Understanding of importance of management strategy
According to the survey of 1500 PCPs what factor had the strongest effect on career satisfaction?
Quality of patient interactions
According to Oxford what is the definition of communication?
The imparting or exchanging of information by speaking, writing, or using some other medium
According to Cambridge what is the definition of communication?
The exchange of information and the expression of feeling that can result in understanding
How can we achieve effective communication? (5)
Respect
Empathy and compassion
Trust
Practice
Patient-centered care
What are 4 aspects that define a patient-centered practice?
Partnership to establish patient needs and desired outcomes
Patient feels in control
Shared decision making (custom management plan)
Not only from clinical perspective
What aspects do we notice during a first impression? How long does it take to judge a person?
Voice pitch (higher=more trustworthy)
Eye contact (attentiveness, confidence)
Handshake (confidence)
Facial expression (trustworthy, likable)
1/10th second
What is important to include in the initial introduction? Why is this important?
Use proper title (respect)
Smile
Handshake when appropriate
Apologize if late
Sets tone for exam
As you walk to the exam room how is communication continued?
Walk next to patient
Initiate casual conversation
How can communication be improved while taking a case history? What is the most important?
Sit at patient’s level
Eye contact
Determine reason patient is seeking care
Listening (MOST IMPORTANT)
Develop proper questions
What is a closed question?
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?
What is an open question?
No right or wrong answer
Gives patient control
Doctor listens, observes, and learns
Ex: What brings you in today?
What are questions that probe?
Seek more info about a topic
Encourage details about info previously mentioned
Ex: Can you tell me more about the pain you’re experiencing?
What can be a disadvantage of using questions that probe?
Over-use can be negative and seem interrogating
What are questions that clarify? What can they help to avoid?
Seek understanding rather than info
Achieve misunderstanding, avoid misinterpretations
Ex: Do you mean the pain spread to your lower eyelid?
What can occur if “questions that clarify” are overused?
May suggest that physician is not able to understand patient
What are questions that lead?
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?
When are “questions that lead” best to avoid?
When goal is to seek a trusting, respectful patient-doctor relationship
What sets the foundation for the exam?
Case history
In what percentage of encounters did the physician interpret the patient’s opening statement?
70%
What occurs when the physician interrupts the opening statement? Average time before physician interrupted?
Potential loss of relevant information
18 seconds (most opening statement were between <60 to 150 seconds)
How has the interruption time during opening statements changed from 2018 to now?
Increased from 11 to 18 seconds
Why is it important to listen to your patient?
Information for diagnosis
Therapeutic
Patient-doctor relationship
Time
When is it appropriate to respectfully interrupt the patient?
Need to ensure we obtain full case history and understand concerns
What two factors influence the decision to interrupt?
Respect for the patient
Quality of the relationship
What is the triple E approach?
Excuse yourself
Empathize with interrupted topic
Explain why you interrupted
What are the 3 basic components of case history?
Development of appropriate questions
Listening
Responding to negative emotions with empathy
