Midterm: Advanced Concepts in Physician-Patient Communication

Question 1

What are some strategies to show empathy and build trust with a patient? (2)

Answer 1

Reflective statements, including echoing and summarizing

Mirroring hand gestures and body language
-shows empathy

Question 2

What are some examples of body language that shows the physician is NOT engaged?

Answer 2

arms across chest, body positioned away from patient, little facial expression

Question 3

What are some actions by the physician that is definitely unethical?

Answer 3

Dating a patient

Prescribing meds to self or family

Question 4

Is allowing patients to call you by your first name or giving your personal phone number unethical?

Answer 4

to some yes, but not everyone agrees

Question 5

Can physicians provide medications to patients not established with that physician?

Answer 5

It is a gray area

-can cause issues if you are audited and meds are missing

Question 6

Is it okay to give money to patients who cannot afford the medication?

Answer 6

Another gray area

-can cause issues if patient uses that money to buy drugs/alcohol

Question 7

What is the most important thing to remember in keeping the patient-physician relationship professional?

Answer 7

Know when to set boundaries

-especially if what they are asking can get you or them into trouble

Question 8

What are the four steps of motivational interviewing? OARS

Answer 8

Open ended questions
Affirmations
Reflective listening
Summaries

Question 9

What are the stages of Behavior Change?

Answer 9

1. Precontemplation: before they have considered
2. Contenplation: are considering behavior
3. Preparation: active planning of behavior
4. Action: putting that preparation into play
5. Maintenance: doing behavior and needs to continue

Question 10

What is a written controlled substance agreement?

Answer 10

a signed agreement between patients and physicians that provide education and expectations to patients

Question 11

What are some common components for the written controlled substance agreements? (3)

Answer 11

• Restricts pt to one opioid or stimulant provider and one pharmacy
• documents proper way to ask for refills
• prescribes how frequently the patient must make appointments for refills

Question 12

What are verbal agreements and when do they occur?

Answer 12

Verbal agreements are between physicians and patients that happen on a daily basis
-uses words like “if” and “when” for when patients do something, like if lose weight, they can stop taking certain drugs, like HTN meds.

Question 13

What is important about verbal agreements?

Answer 13

The physician clearly states, and ensures patient understands agreement

Question 14

What are some risk factors that can affect informed consent? (4)

Answer 14

Pt <18 or >85
Chronic neuro or psych patient
Low education level
Significant cultural or language barrier

Question 15

What type of informed consent:

patient passively goes along with what the physician does during the encounter without prolonged discussion of risks or benefits and without documentation?

Answer 15

Implied consent

-needs good communication

Question 16

What type of informed consent:

Patient verbally agrees to specific procedure or treatment after discussion of risks and benefits as well as what will happen during the procedure and is documented

Answer 16

Verbal consent

Ex: “after verbal consent, HVLA was performed”

Question 17

What type of informed consent:

Patient fills out and signs form acknowledging risks and benefits

Answer 17

Written consent

Question 18

Does the physician go over the document with the patient for written informed consent?

Answer 18

Yes

Question 19

What does Title VI of the Civil Right Act specify when it comes to pts who speak a foreign language?

Answer 19

An interpreter must be provided to all patients

Question 20

Should children <18 be used as an interpreter?

Answer 20

Only if its an emergency

Question 21

What is a good practice to use when using an interpreter?

Answer 21

Speak to the patient, not the interpreter

-then pause for interpretation and wait for response

Question 22

Do you document the interpreters name after the encounter?

Answer 22

Yes!

Question 23

Who is the most preferred interpreter?

Answer 23

A certified medical interpreter

• family may have own agenda or provide outside advice
• More Confidential
• Helps physician maintain control of conversation
• family may be unfamiliar with medical jargon, or certain subjects may be sensitive