PCM Lecture (11) Successful Communication with the Patient PDF

Level 1 - Semester 1 PCM LECTURE (11) SUCCESSFUL COMMUNICATION WITH THE PATIENT DR ZIAD MAHANA  PCM LECTURE - 3 0 PHYSICIAN-PATIENT...

Level 1 - Semester 1 PCM LECTURE (11) SUCCESSFUL COMMUNICATION WITH THE PATIENT DR ZIAD MAHANA  PCM LECTURE - 3 0 PHYSICIAN-PATIENT COMMUNICATION Ai o dCtR-pTiNtCoMuIcTiN ❶ Increases: 1) Patient satisfaction. 2) Understanding of illness and management. 3) Patients’ compliance with treatment. 4) Levels of job satisfaction ❷ Reduces the risk of complaint and litigation. eEmNt o eFeTiEOmUnCaIo wThPaIeT ❶ SETTING THE STAGE ⎚ Appropriate greeting - language. ELICITING ❷ ⎚ Open-ended, active listening, summarizing to convey an understanding INFORMATION ① Assess what is known - what needs to be conveyed - prioritize. SHARING ❸ ② Allow questions. INFORMATION ③ Ask the patient to summarize understanding. ⎚ Shared decision making… ❹ DECISION MAKING (Help the patient take the decision - But do not make it for him or her). ❺ SUPPORT ⎚ Empathy and respect - be available. Dr. Ziad Mahana 1  PCM LECTURE - 11 Ho t dVeOpAOo dCtRs- pTiNt’ rLaIoShP § Gauging correct amount - type of information to give to each individual patient. § Providing explanations that patient can remember & understand, & which relate to the patient’s illness framework. PATIENT § Using an interactive approach to ensure a shared understanding of the COMPREHENSION problem with the patient. § Follows helical model… (i.e. what I say influences what you say in a spiral fashion & coming back around spiral of communication at a little different level each time is essential). § Involving the patient & collaborative planning increase patient’s commitment & adherence to plans made. PATIENT § Enabling the patient to become part of a collaborative process. INVOLVEMENT § Continuing to allow the patient to feel part of a collaborative process and to build the doctor-patient relationship for the future. § Identifying as far as possible all problems or issues patient has come to discuss. CARING § Shows empathy and learn how to handle emotional outbreaks. PLAN § Establishing an agreed agenda or plan for the consultation. ESTABLISHMENT TIME USE § Making efficient use of time in the consultation. § Closing the interview. § Confirming the established plan of care. IN THE END § Clarifying next steps for both doctor and patient. § Maximizing patient adherence and health outcomes. Dr. Ziad Mahana 2  PCM LECTURE - 11 QuStOn t aKOuSeFFtRAc cNsLtTiN ❶ Was I curious? Do I know significantly more about this person as a human being than before they came ❷ through the door? ❸ Did I listen? ❹ Did I make an acceptable working diagnosis? ❺ Did I explore their beliefs? ❻ Did I use their beliefs when I started explaining? ❼ Did I share options for investigations or treatment? ❽ Did I share in decision-making? ❾ Did I make some attempt to see that my patient understood? ❿ Did I develop the relationship? BlCkNgBeAvOr o cMmNiAtOn ❶ Asking closed-ended questions. ❷ Not dedicating adequate time for consultation and behaving as if they are busy. ❸ Looking away and not establishing eye contact. ❹ Giving explanations and solutions early even before patient completes the story. ❺ Frequently checking the time. ❻ Responding or taking phone calls or texting. ❼ Demonstrating a lack of interest. ❽ Asking the patient to tell a short story. ❾ Taking notes or using a computer in a manner that the patient will be ignored. ❿ Engaging in other activities during the consultation. Dr. Ziad Mahana 3  PCM LECTURE - 11 CoMo eRoSNOmUnCaIo ① Inappropriate facial expression or hand gesture. ❶ NON VERBAL ② Lack of eye contact. ❷ LISTENING ⎚ Interrupting too soon. ① Too little - too technical. ❸ INFORMATION ② Use defensive words. ❹ VOICE ⎚ Inappropriate volume - speed - pitch. ❺ ATTITUDE ⎚ Lack of empathy & respect. Dr. Ziad Mahana 4