Improving Doctor Patient Relationship

Dr. Ashraf A . Amir

BSc,MBBS,SBFM,ABFM

Consultant Family Medicine - IMC

Do you feel a bit frustrated when your patient don't follow your recommendations ?

Poor Doctor Patient relationship ..

Facts :
Doctors do more talking than listening.

72% of the doctors interrupted the patients opening statement after an average of 23 seconds. Patients who were allowed to state their concerns without interruption used only an average of 6 more seconds.
(JAMA)

Facts :
Doctors often ignore the patients
emotional health.
when patients dropped emotional clues or talked openly about emotions, the doctor seldom acknowledged their feelings. Instead the conversation was directed back to technical talk.

Facts :
Doctors underestimate the amount of information patients want and overestimate how much they actually give.
Study of 20-minute office visits, doctors spent about 1 minute per visit informing patients, but believed they were spending 9 minutes per visit doing so.

Facts :
Doctors who cant communicate are more likely to end up in court.
An analysis of 45 malpractice cases found that many of the doctors being sued delivered information poorly and devalued the patients views.

Facts :
Some doctors view patients as an unreliable narrator. Patients do not care how much you know until they know how much you care. Patients who feel at ease and who are encouraged to talk freely are more likely to disclose the real reason for consultation.

Good Doctor Patient relationship:

Developing rapport to enable the patient to feel understood, valued and supported.

Encouraging an environment that maximizes accurate and efficient information gathering, planning & and explanation

Good Doctor Patient relationship:

Involving the patient so that he/she understands and is comfortable with the process of the consultation. Increasing both the physicians and the patients satisfaction with the consultation. Developing and maintaining a continuing relationship of trust & respect over time.

Good Doctor Patient relationship:

Insure patient compliance on treatment . Placebo effect.

Doctor Patient relationship built on:

Honesty . Confidentiality . Trust .

Mutual respect .

Facts :
Doctor

Compliance

Good relation
skills
Patient

Do Doctors need communication ?

Patients are humans with sensitive needs. Poor communication causes a lot of medico-legal and ethical problems. Patients want to play active role. Patients become more doctors dependents. Identify patients' problems more accurately

Good communicator has:

Empathic Receptive Open

HEART

EAR

MIND

Non verbal communication :

Smile.
Open posture . Forward lean. Eye contact. Touch.

Communication tips :
Allow enough time.( elderly patients ) Avoid distractions . Sit face to face. Maintain eye contact

Listen.
Bio- psycho- social model.
(holistic approach)

Communication tips :
Open ended questions. Speak slowly, clearly Use short, simple words and sentences. Address idea ,concern and expectation
(ICE).

Effect of the problem on patient.

Communication tips :
Stick to one topic at a time . Simplify and write down your instructions . Use charts, models and pictures. Frequently summarize the most important points.

Communication tips :
Search for hidden agendas. Shared understanding. Opportunity to ask questions. Empower patient in monitoring their disease.

Red flags.

Question to ask your self after consultation?

Did I listen? Did I use their beliefs when I started explaining? Did I share options for management? Did I share in decision-making? Did I attempt to see what patient understood?

Question to ask your self after consultation?

Did I make an acceptable working diagnosis?

Did I develop the relationship? .

Yes .
Perfect consultation Perfect relationship.

Take home massage .

Trust in Doctors is high, yet not blind .

Thank You .