The Patient-Doctor Relationship

1. The Patient-Doctor Relationship Sonia Sehgal, M.D. Course Director CFI Associate Clinical Professor Department of Internal Medicine UC Irvine Program in Geriatrics This work was supported by a grant From the Donald W. Reynolds Foundation

2. Objectives • Understand why patient-doctor communication is key to a successful relationship • Learn basic communication strategies for an improved patient-doctor experience

3. The Patient-Doctor Relationship • Class exercise: • Tell me about your most memorable positive experience with a physician (when you were a patient)

4. The Patient-Doctor Relationship • Class exercise: • Tell me your most negative experience

5. The Patient-Doctor Relationship • What does being a doctor mean to you?

6. Communication • Patient-Doctor communication is important • Improved satisfaction • Improved compliance • Improved decision making • Better health outcomes • Decreased malpractice claims

7. Communication Skills • Essential for diagnosing and treating illness • Essential in establishing a meaningful patient-doctor relationship • Facilitates educating and counseling patients

8. Communication • Information gathered must be: • Objective • Accurate • Precise

9. A model patient-doctor relationship • Trust • Compassion • Open and honest communication • Respect

10. Why is Doctor-Patient Communication Unique? • Trust • Patients on the first visit share their most personal information to someone they have never met before • They look to you for guidance when making critical health care decisions

11. Why is Doctor-Patient Communication Unique? • Trust • Within minutes of meeting, patients are often required to disrobe for a physical examination and are placed in a vulnerable situation

12. Communication • Who will you be communicating with? • Patients • Families • Colleagues • Other health professionals

13. Patient Communication • Patients who feel at ease are more likely to tell you their reason for coming to the doctor’s office • Be yourself! • Show true interest

14. The Physician’s Duties • Respects the patient • Ensures privacy and trust of confidential information • Demonstrates genuine concern for patient’s health • Limits distraction to provide patient undivided attention

15. Respect • Introduce yourself • Patient • Family • Caregiver

16. Respect • Explain your role and goal for the interaction

17. Respect • If appropriate shake hands • Always address the patient as: Mr., Mrs., Ms, etc.

18. Empathy • To understand a person’s experience • Different than sympathy • Requires • Active listening • Interest in patient’s experience

19. Objectivity • Removing your own beliefs and values • Avoid judgmental attitudes • IV Drug Abuse • Education • Socioeconomic status • Language/Cultural differences • Ageism

20. Active Listening Skills • Respect the patient as a whole person, not a diseased body • Use confirmatory statements: • “Yes” • “Tell me more about that” • Allow the person to tell their whole story without unnecessary interruptions

21. Active Listening • Don’t be afraid of silence

22. Body Language • Examination room configuration • Sitting/Standing • Eye level • Eye contact • Note taking • Posture • Hurried speech

23. Body Language • Patients notice more than you think • 2/3 of communication is non-verbal • Appropriate use of touch

24. Patient-Doctor Communication:Key Points • Ask about expectations, feelings and concerns • Show concern for comfort and modesty • Give an opportunity to express feelings and concerns • Encourage patients to ask questions

25. Communication skills can be developed with practice, patience and a willingness to learn