Exam 1 - Communication Skills Flashcards
Communication impacts
Diagnosis Adherence Patient satisfaction Provider satisfaction Malpractice litigation
What is the most important event leading up to litigation?
According to defense attorneys, communication breakdown is the most important event leading to a patient’s decision to litigate.
When doctors interrupt patients during patient interviews, what happens?
It has been proposed that current interviewing practices produce biased and incomplete data about the patient.
The 2 F’s involve medical knowledge.
Find it
Fix it
The 4 E’s involve communication skills.
Engage the patient
Empathize with the patient
Educate the patient
Enlist the patient in his own health care
Is the interview an inquiry or an inquisition?
Non-biased, non-judgmental, non-accusatory.
Engagement: What does interruption say about roles?
Hinders the patient-provider relationship.
Outcomes of Successful Engagement
Provider develops a more accurate diagnosis.
> Obtain more information about the illness.
>Understand the effect of the illness upon the patient.
Increases the likelihood of patient adherence.
>Establish an improved provider-patient relationship.
>Discover the health belief system of the patient.
Establishes an effective patient-provider relationship.
> Create an opportunity for partnership.
> Demonstrate interest in the patient’s point of view.
> Provide the patient with an opportunity to tell own story.
Empathy
Being an empathetic provider = a good listener and patient advocate.
From a patient’s standpoint, empathy means
-Being Seen
-Being Heard
-Being Accepted
An empathetic provider will gain patient trust readily.
Empathy: Being Seen
Always see new patients with their clothes on at the beginning of the interview. Why?
“Look” at the patient and mentally note
Facial and bodily expressions of feelings.
Mode of dress and physical presentation.
Notable physical characteristics.
Eliminate physical barriers – desks, charts, etc. Keep eye-to-eye contact.
Sit or stand at your patient’s same level.
Empathy: Being Heard
Use the language of the patient.
Speak to the patient in terms that are easy to understand.
Give feedback to the patient.
Ask for feedback from the patient.
Invite the patient to tell his/her story; welcome the story.
Empathy: Being Accepted
Judge ONLY the behavior not the person.
Communicate your understanding of the patient’s feelings and values.
Do so in a way that the patient has a chance to correct you if you misunderstood.
Use appropriate self-disclosure.
Outcomes of Establishing an Empathic Connection
Reduced anxiety related to isolation or abandonment.
Improve adherence.
Increased level of connection.
Reduces frustrations!
Patient Education
Assume the patient will ask these questions, so be prepared to offer answers without being prompted.
What has happened to me?
Why has it happened to me?
What is going to happen to me?
What are you (they) doing for me (to me)?
Why are you (they) doing this rather than that?
Will it hurt me or harm me? How much? How long?
When and how will you know what all this (tests, procedures, etc.) means?
When and how will I know what it means?
Enlistment
The challenge is to enlist the patient as an active decision maker and participant in her/his own health care.
Active decision making can not be assumed.
Compliance can not be assumed.
Provider action influences both participation and compliance.
