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INTRODUCTION TO PHYSICIAN-PATIENT COMMUNICATION
Ildikó Bán MD Depts. of Family Medicine and
General Internal Medicine, University of Pécs
2007
WELLCOME!
WHY IS COMMUNICATION SKILL TRAINING IMPORTANT FOR A FIRST YEAR MEDICAL STUDENT?
What we want and don’t want
THE IMPORTANCE OF THE COMMUNICATION SKILLS
in foreign countries….. role plays joint consulting video taped consultations case reports
WHAT SHALL WE DO IN THIS SEMESTER?
6 lectures on doctor patient communication, video taped situations
4 small group seminars, role playing interactive teaching methods about the grading feedback
STUDY
What makes a doctor good doctor?
from the aspect of the patients
STUDY
72% the most important the personal doc-pat. realitionship (pays attention, listents to the patient, shows empathy)
28% the most important the skill and the knowledge (competence, efficiency, time saving)
GOALS
Patient’s side:
solving the problem understanding the nature of his
problem understanding his role in the process
GOALS Doctor’s side:
getting the information is there anything else? understanding the problem actual physical and psychological status planning convincing the patient (explanation..) Collaboration with the patient
INTRODUCTION TO PHYSICIAN-PATIENT COMMUNICATION
Ildikó Bán MD Depts. of Family Medicine and
General Internal Medicine, University of Pécs
2007
SPECIAL FEATURESSPECIAL FEATURES
previous experienceslots of personal and anamnestic detailsrelatives, circumstances, envirnomentdifferent places (office, patient’s home)
STEPS OF THE DOCTOR PATIENT INTERACTION
GREETING INTRODUCTION INTERVIEW PHYSICAL EXAMINATION DISCUSSION, DECISION SAYING GOOD BYE
DOCTOR PATIENT ENCOUNTERDOCTOR PATIENT ENCOUNTER
GREETING:
depends:- age, sex- personality
mistakes: - intimate, intrusive- self confident- to miss it
SAYING GOOD BYE
INTRODUCTION
INTERVIEW
PHYSICAL EXMINATION
DISCUSSIONDECISION
GREETINGGREETING
DOCTOR PATIENT ENCOUNTERDOCTOR PATIENT ENCOUNTER
INTRODUCTION:
Depends: First meet?
mistakes: You miss it The patient starts
SAYING GOOD BYE
INTRODUCTIONINTRODUCTION
INTERVIEW
PHYSICAL EXAMINATION
DISCUSSIONDECISSION
GREETING
Don’t be afraid to say you are a medical student!
DOCTOR PATIENT ENCOUNTER
INTERVIEW: The patient’s goal-let the P. talk Problem oriented proper
questions Focus on the most important-
ask back mistake:
„too much information” „disease oriented”
SAYING GOOD BYE
INTRODUCTION
INTERVIEWINTERVIEW
PHYSICAL EXAMINATION
DECISIONDISCUSSION
GREETING
DOCTOR PATIENT ENCOUNTERDOCTOR PATIENT ENCOUNTER
PHYSICAL EXAMINATION:
Very intimate Cause as little discomfort as
possible! Keep on talking!
SAYING GOOD BYE
INTRODUCTION
INTERVIEW
PHYSICAL EXAMINATION
PHYSICAL EXAMINATION
DISCUSSIONDECISION
GREETING
DOCTOR PATIENT ENCOUNTER
DISCUSSION, DECISION: Suspected diagnosis plan, steps, prognosis BE UNDERSTANDABLE!mistakes:
Not understandable Not controlled
The doctor makes the decision THE TRUST IS FUNDAMENTAL The next appointment
SAYING GOOD BYE
INTRODUCTION
INTERVIEW
PHYSICAL EXAMINATION
DISCUSSIONDECISION
DISCUSSIONDECISION
GREETING
DOCTOR PATIENT ENCOUNTER
SAYING GOOD BYE:
NEVER LET THE PATIENT GO WITH UNANSWERED QUESTIONS
Never forget to say good bye Show that you care about your
patient
SAYING GOOD BYESAYING GOOD BYE
INTRODUCTION
INTERVIEW
PHYSICAL EXAMINATION
DISCUSSIONDECISISON
GREETING
DIFFICULT SITUATIONSDIFFICULT SITUATIONS
Angry patient Insecure patient Nervous patient Suicidal Dying patient
POWER OF COMMUNICATION
„Doctors who communicate poorly may never be forgiven, those who do it well never will be forgotten.”
SEE YOU SOON!
