How Physicans Can Communicate With Their Patients to Provide Quality Care

If you have your patients’ best interests at heart, it’s not enough just to hire the most qualified medical staff and equip them with quality medical and surgical supplies; you also need to promote effective communication in your medical practice to make sure your patients receive the best possible care.

Research has shown that if a doctor doesn’t listen to their patients, important health cues are missed, which can result in illnesses being misdiagnosed. In addition, if a patient doesn’t understand what their doctor has told them, they may struggle to follow instructions, which can result in preventable hospitalizations, an increased risk of complications and poor outcomes in general.

Not only does poor communication have a negative impact on the quality of care, it also increases costs. Now that Medicare rules have changed in a bid to improve patient safety^[1], healthcare providers face the possibility of receiving less money if their patient-satisfaction scores are too low or they have too many preventable readmissions.

Poor doctor-patient communication is a contributing factor in at least 40% of malpractice suits, while malpractice insurers claim that if physicians have taken the time to nurture a positive relationship with their patients, they are less likely to face a lawsuit, even if they make a mistake.^[2]

Given how important good communication is to running a successful healthcare facility, what can medical professionals do to improve their relationship with their patients?

1. Use Active Listening

This is one of the most basic ways in which physicians can improve their communication skills, yet it is frequently overlooked in the haste to deal with one patient and move on to the next. You need to engage with your patients and make sure that you truly understand what they are telling you.

Active listening is more than simply hearing the words your patient is using. It involves all the senses and paying attention to non-verbal cues, which will reveal more than just the verbal response.

It is also crucial that you present yourself as being interested in what your patient has to tell you. As Dr. Leon Goldstein puts it: “You don’t stare at the computer the whole time. You look at your patient, you look at the situation, you are there, involved. I don’t have a nurse that takes out my sutures. I could, but I’d rather do it myself, because it gives me a little bit of extra time with the person to find out how they are really doing, what concerns they have, and that gives them an opportunity to ask me questions they probably wouldn’t ask otherwise. If they have any concerns about what we did or something else, that really gives a chance for them to communicate, and that is the important thing.”

Smiling, nodding, maintaining eye contact, and using simple responses, such as ‘yes’ or ‘I see,’ all tell the patient that you are paying attention and want them to continue with the discussion. This will help to put them at ease and make it easier for them to be honest with you about their symptoms and health regimen.

In contrast, fidgeting, doodling, interrupting, etc. all create an impression that a healthcare professional has no real interest in their patient, which discourages them from opening up about their issues.

2. Use Open Ended Questions

In order to fully assess your patients’ needs, a physician will need to ask relevant questions about why they have sought medical help and what they want you to do. Keep these questions open ended where possible, rather than eliciting a ‘yes/no’ response. This will allow the patient to explore their current situation and go into depth about their symptoms.

Open ended questions also encourage in depth discussion that will provide a wealth of useful information to the medical practitioner. It may be that a patient has unrealistic expectations or they are determined on a course of treatment that is not in their best interests. They may also be afraid of what their illness could mean in terms of quality of life or needing to make lifestyle changes, so open ended questions give the physician the chance to allay those concerns.

You may find that using open ended questions with your patients results in your seeing the same themes recurring in their answers. If this is the case, you may want to use this information to implement new strategies moving forward to provide a compassionate service that genuinely empathizes with your patients’ needs.

Once a physician has gained a complete picture of their patient’s priorities and preferences, then both parties can move forward to make collaborative choices that are patient-centered. There is evidence to suggest that these types of discussions result in terminally ill patients undergoing fewer intensive intervention in the last week of life, which results in not only lower expenditure on health care, but also an improved quality of life in those precious final days.^[3]

3. Use Plain English

After years of study at medical school, it can be easy to forget that not everyone understands what ‘hypertension’ or ‘contusion’ means. When you remove medical terminology from your lexicon when speaking with patients, it makes it easier for them to understand their diagnosis and recommended treatment. If you go out of your way to ensure they have a full comprehension of their condition, they are more likely to ask clarifying questions, follow your recommendations, and be willing to speak up if they feel the need, increasing overall patient satisfaction.

Tell your patients that they have suffered a blood clot instead of an embolism or have shingles instead of herpes zoster. Although it can be frightening to receive a diagnosis, when you meet your clients at their level of understanding, it goes a long way to put them at ease and allows them to express any worries they may have.

4. Have Your Patient Paraphrase Your Instructions

A good way to ensure that your patient has fully understood what you’ve explained to them is to ask them to explain to you in their own words what it is you’ve said. This ‘teach-back’ method is especially useful with patients who have a low level of medical comprehension, but it is worth using with all patients, regardless of history or background, to improve compliance and understanding.

5. Make The Most Of Technology

Research carried out at the John Hopkins Bloomberg School of Public Health showed that most patients in the U.S. would prefer to communicate with their doctor over Facebook than in person.^[4] While there are definite benefits to a face-to-face consultation, this doesn’t mean that social media and email can’t have an effective place in patient care.

In October 2014, the National Institutes of Health paid out over $11 million to researchers to examine how social media could be used to understand, prevent and tackle drug and alcohol addiction. As a result of that research, the NIH now intends to use Facebook and Twitter to identify and address myths concerning addiction, as well as disseminating accurate information to the public at large. Social media can be a highly effective way for medical professionals to educate their patients about healthcare issues such as when to get a flu jab.

Email can also play an important role in empowering patients. A patient may not fully comprehend or remember everything that was said to them during a consultation, even when they’ve brought someone with them for support, and they may not feel capable of speaking up if they are unhappy or need further explanation. When you combine this with the use of clinical jargon, it is little wonder that some patients leave their doctor feeling confused and concerned.

Emailing your patient to follow up on an appointment allows them to read the details of their diagnosis and medical advice as many times as they need to understand it all. They can look up medical terms that they didn’t understand or do further research into their condition to understand why you’ve made the recommendations you have. Emailing patients can have a very positive impact on outcomes.

There are a few problems with using email to communicate with your patient. Sending an email is currently unlikely to be reimbursed, and many medical professionals prefer to be paid for every task they carry out. In addition, there are issues over confidentiality and the possibility of liability if a patient comes to harm due to email miscommunication. However, technology and best practice protocols go a long way to address these issues, which do not outweigh the potential benefit.

6. Don’t Be Afraid To Get Help

Communication is a learned skill. So-called ‘soft skills’ are rarely covered in depth in medical schools, making it imperative that medical professionals seek out further training to improve how they communicate with their patients. Issues over reimbursement and the need to see more patients per hour mean that there is a pressure to forget about empathy and compassion in order to end consultations as quickly as possible.

Good communication has been proven to have a positive impact on outcomes^[5] and all healthcare providers would benefit from refreshing their communication skills on a regular basis. With studies demonstrating the therapeutic value of good communication, showing that it can reduce pain, improve blood pressure and increase function, there really is no reason not to keep communication as a top priority.^[6] Leading physicians instil positive communication into the heart of every interaction with their patients, which not only improves patient care, but helps health care facilities retain a high level of patient satisfaction.

Helping Patients Communicate With Their Physicians

In our next blog post, we’ll look at what patients can do to communicate effectively with their physicians/healthcare providers, as well as family members they may be a caregiver to. After all, communication is a two way street and it’s important that patients know how they can get the most out of their physician.

Medical professionals – what techniques have you found effective in patient communications? Are there any things you can do better? What’s the one piece of advice you’d give to another physician about communicating with their patients? Let us know about your experience in the comments.

Sources:
^[1] https://www.linkedin.com/pulse/hospitals-face-medicare-penalties-patient-falls-denise-skevington
^[2] https://www.wsj.com/articles/SB10001424127887323628804578346223960774296
^[3] http://content.healthaffairs.org/content/29/7/1310.full
^[4] http://www.medicaldaily.com/dr-facebook-most-patients-would-rather-communicate-their-doctors-using-social-media-340120
^[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4413084/
^[6] http://www.hhnmag.com/articles/3451-improving-physicians-communication-skills