Effective Communication

Question 1

Importance of effective communication

Answer 1

1. Altruistic reasons
2. Pt. #1 complaint = bad communication
3. Improved outcomes
4. Reimbursement modes -> performance based
5. Sued less
   A. Apology and offer compensation = 64% dec in claims

Question 2

Goals of effective communication

Answer 2

1. Create trust in relationship
2. Facilitate info exchange
3. Partnering in decision making -> best outcome

Question 3

Societal expectations of drs.

Answer 3

1. 1950s-1970s:
   A. Dr.-focused: paternalistic
   B. Don’t question Dr.
   C. Sometimes bad things happen and medicine won’t save you

2. Now:
  A. Pt-centered
  B. Pt. Challenge us (w/ info)
  C. High-tech expected
  D. Should be able to prevent most unexpected outcomes and treat most diseases

Question 4

Motivational interviewing (MI) essential concepts

Answer 4

1. Started by psychologist 1983 working w/ alcoholics
2. Key concepts:
   A. Collaborative effort
   B. Recognize where pt. Is on change spectrum
   C. Respect pt autonomy (empowering)
3. Ambivalence/hesitation to change is natural
4. Brow-beating doesn’t work
5. Doesn’t mean you agree

Question 5

MI benefits for pts

Answer 5

1. Believe in pt ability to change
2. Show empathy
3. Dance instead of tug-of-war w/ resistance pts
4. Recognize when they are ready to take action

Question 6

MI technique (OARS)

Answer 6

1. Open-ended questions
2. Affirmation (encouragement)
3. Reflective listening (repetition)
4. Summarizing

Question 7

MI challenges

Answer 7

1. Pressure by payers - see more pts
2. Time constraints
3. Required patience and empathy
4. Misunderstandings