The Patient-Doctor Relationship

Sonia Sehgal, M.D.Course Director CFI

Associate Clinical ProfessorDepartment of Internal MedicineUC Irvine Program in Geriatrics

This work was supported by a grant From the Donald W. Reynolds Foundation

Objectives

• Understand why patient-doctor communication is key to a successful relationship

• Learn basic communication strategies for an improved patient-doctor experience

The Patient-Doctor Relationship• Class exercise:

– Tell me about your most memorable positive experience with a physician (when you were a patient)

The Patient-Doctor Relationship• Class exercise:

– Tell me your most negative experience

The Patient-Doctor Relationship

• What does being a doctor mean to you?

Communication

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

Communication Skills

• Essential for diagnosing and treating illness

• Essential in establishing a meaningful patient-doctor relationship

• Facilitates educating and counseling patients

Communication

• Information gathered must be:– Objective – Accurate– Precise

A model patient-doctor relationship• Trust• Compassion• Open and honest

communication• Respect

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

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

Communication

• Who will you be communicating with?– Patients– Families– Colleagues– Other health professionals

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

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

Respect

• Introduce yourself– Patient– Family– Caregiver

Respect

• Explain your role and goal for the interaction

Respect

• If appropriate shake hands

• Always address the patient as: Mr., Mrs., Ms, etc.

Empathy

• To understand a person’s experience

• Different than sympathy• Requires

– Active listening– Interest in patient’s experience

Objectivity

• Removing your own beliefs and values

• Avoid judgmental attitudes– IV Drug Abuse– Education– Socioeconomic status– Language/Cultural differences– Ageism

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

Active Listening

• Don’t be afraid of silence

Body Language

• Examination room configuration• Sitting/Standing• Eye level• Eye contact

– Note taking• Posture• Hurried speech

Body Language

• Patients notice more than you think– 2/3 of communication is non-

verbal • Appropriate use of touch

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

Communication skills can be developed with

practice, patience and a willingness to learn