Communication Challenges Flashcards
effectiveness of non-verbal / verbal communication
80/20
What are the common communication pitfalls? (7)
Mind-reading Overloading Defensiveness Strong emotions Leading questions Ignoring nonverbal cues Interrupting information delivery
What are the common physician pitfalls?
Avoid standing over your patients Staring at a clipboard, computer or the chart Avoid Mindreading – if you sense inconsistent messages, ask the patient Ignoring nonverbal cues address them directly Unintentional nonverbal cues Unsure of self Busy (pager, interruptions, etc..) Reaction to patient concerns/comments
What should you be aware of when dealing with difficult patients?
Be aware that seeking medical care is anxiety provoking and often brings out the worst in people
What are the 6 styles of difficult patients?
Dependent and demanding patients Orderly and controlled patients Dramatizing or manipulative patients Long-suffering or masochistic patients Guarded or paranoid patients Superior patients
What is the cycle of behavior for dependent and demanding patients
Initial interactions are very positive (you are the only person who understands them)
An increase in attention and care is requested
Efforts by the physician and office staff are never enough and do not satisfy the patient
Patient withdraws and/or blames the physician for inadequate care
How do you manage the dependent and demanding patients?
Overtly set limits on frequency and mode of communication (phone calls, e-mail, etc..)
Avoid making promises that you cannot keep (I’ll talk with the insurance company)
Emphasize the patient’s responsibility in their own health care
Remind the patient of the time constraints
Minimize credit for remission of illness as it inevitably brings about blame for onset of illness
What is the common behavior patterns in the orderly and controlled patient?
Very conscientious and knowledgeable about medical care
Much detail and thoroughness regarding their approach to their health care
They use information and knowledge as a way to maintain control
They need to sense of control to manage their anxiety
How to manage the orderly and controlled patient?
Be systematic in the clinical interview; state what you are doing and why
Explain topics of discussion in detail
Don’t leave loose ends
Summarize often
Avoid statements that are vague or unfounded
What is the common behavior patterns in the Dramatic or manipulative patient?
Penchant for dramatic statements (‘the worst ever’, ‘the longest I’ve ever seen..’)
Strong need to be heard and validated
Wants to be acknowledged by the physician as being in pain, as suffering or as special
May comment on the physicians person (appearance, affect, etc..)
How to manage the dramatic or manipulative patient?
Allow the patient to tell his/her story
Be gentle yet firm; keep boundaries in mind
Utilize good listening skills; convey that the story has been heard
Keep comments descriptive rather than judgmental (‘I see this happening’ rather than ‘Why do you keep…?’)
Redirect personal comments back to the patient
What are the common behavior patterns in the long-suffering or masochistic patients?
Reject help as they explain their concerns/symptoms
Nothing seems to work, or has worked in the past
Much reported self sacrificing to help others
When one areas is resolved often times another problem appears
Cannot accept hope or possibilities
How do you manage the long-suffering or masochistic
Set realistic goals (“well, lets try this and see what happens” not “let’s try this and see if it works”)
Avoid optimistic statements or seeking out the strengths or possibilities
Reflect the patients perspective
They often like the idea of ‘helping’ the provider by allowing the provider to treat them
Good for physicians in training
What are the common behavior patterns in the guarded paranoid patients?
Mistrusting of the health care field in general
Will often tell stories of medical errors in their past
Physicians often feel defensive with these patients
Express frustration and blame medical incompetence when they can’t get what they want
How do you manage the guarded paranoid patients?
Understand that it is not about you! Be clear and specific with explanations Clarify your role and it’s limitations Acknowledge the patients’ suspicions Restate your understanding of the patients beliefs
