Midterm: Advanced Concepts in Physician-Patient Communication Flashcards

1
Q

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

A

Reflective statements, including echoing and summarizing

Mirroring hand gestures and body language
-shows empathy

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2
Q

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

A

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

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3
Q

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

A

Dating a patient

Prescribing meds to self or family

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4
Q

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

A

to some yes, but not everyone agrees

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5
Q

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

A

It is a gray area

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

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6
Q

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

A

Another gray area

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

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7
Q

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

A

Know when to set boundaries

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

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8
Q

What are the four steps of motivational interviewing? OARS

A

Open ended questions
Affirmations
Reflective listening
Summaries

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9
Q

What are the stages of Behavior Change?

A
  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
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10
Q

What is a written controlled substance agreement?

A

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

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11
Q

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

A
  • 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
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12
Q

What are verbal agreements and when do they occur?

A

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.

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13
Q

What is important about verbal agreements?

A

The physician clearly states, and ensures patient understands agreement

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14
Q

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

A

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

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15
Q

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?

A

Implied consent

-needs good communication

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16
Q

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

A

Verbal consent

Ex: “after verbal consent, HVLA was performed”

17
Q

What type of informed consent:

Patient fills out and signs form acknowledging risks and benefits

A

Written consent

18
Q

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

A

Yes

19
Q

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

A

An interpreter must be provided to all patients

20
Q

Should children <18 be used as an interpreter?

A

Only if its an emergency

21
Q

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

A

Speak to the patient, not the interpreter

-then pause for interpretation and wait for response

22
Q

Do you document the interpreters name after the encounter?

A

Yes!

23
Q

Who is the most preferred interpreter?

A

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