By Neil Baum, MD
Most of us like to think of ourselves as good to excellent communicators. However, if we were to survey our patients about our communication skills, we would find, to our dismay, that we are deficient in our ability to receive and transmit information to our patients.
A study that monitored provider-patient interactions found that most healthcare providers will interrupt a patient only sixteen seconds after the patient starts talking. It is hardly surprising that physicians receive low scores from our patients regarding our communications skills.
You can expect in the near future that healthcare providers are going to be compensated according to their communications skills. Many pay for performance (P4P) programs will base their compensation at least in part on patient satisfaction, which is highly dependent upon provider communication skills.
This article will provide nine suggestions that will enhance your communications and thus enhance your patient’s experience with you and your business.
- The first interaction with the patient.
Many of us would start the patient interview with “What brings you to the office today?” or “Why did Doctor X refer you to our office?” What you see as efficiency and professionalism, the patient may perceive as “He’s obviously in a hurry; he’s not interested in me as a person, only as a medical record.”To avoid this inaccurate perception, we suggest that the first two minutes of the new patient interview be devoted to non-medical questions. Examples include “What kind of work do you do?” “Where do you work?” “How long have you been retired?” “Where do you live?” Usually one of these questions will lead to additional talking points that make the patient feel you are interested in them as a person and not as an organ system.
- Ice breakers to use for established patients.
For returning patients, we suggest that the first thirty seconds be dedicated to a non-medical discussion. “How was your vacation?” “How are your children?” are examples of non-medical ice-breakers that allow patients to believe you are as interested in them as you are about their symptoms.
- Ending the patient encounter.
Many of us, particularly those of us in medical practices, end the interaction by giving the patient a prescription, handing them their chart with the superbill and handing them off to the nurse or receptionist so that they can make their next appointment. This method can lead to the “door knob” question which occurs the moment you place your hand on the door knob and the patient tells you that they have one more question that they would like to ask.You can avoid this scenario by asking every patient “Have I answered all of your questions?” or “Is there anything we haven’t covered that you would like to discuss on your visit today?” Ending each encounter with these kinds of questions assures you that patients are satisfied with their encounter with you and the practice.
- Communicate with patients at the same eye level.
Effective communication is difficult if you are standing up and the patient is seated. Standing while the patient remains seated puts you in a dominating position. As a result, even though it seems like a subtle distinction, your patient may fee uncomfortable or non-receptive if you are not at the same eye level. Avoid patient discomfort by sitting when the patient is sitting and making every effort to remain at the same eye level as your patient.
- Talk to your patients when they are fully clothed.
Most patients feel uncomfortable and exposed when a healthcare provider talks with them while they are wearing only a patient gown. Patients hear you better when they are not having a simultaneous internal self-talk conversation about how they wish they could put their clothes back on.Therefore, we suggest allowing all patients to get dressed before you return to the exam room for a discussion of their problem, your findings, and your recommendations.
- Avoid barriers between doctor and patient.
If you speak to a patient in your consultation office, avoid a conversation with you on one side of a desk and the patient on the other. Ideally, both you and your patient can sit on the same side of the desk or if you are in the exam room, have your discussion without any physician barriers between you and your patient.
- Empower your patients.
If your patient needs to have blood drawn, the patient should be asked which arm they would like to use for the blood draw. Many patients know which arm has a better vein from their previous experiences. Regardless, many patients may have a preference of which arm they want to use. Even simple courtesies empower your patients, which enhances your communication and their perception of your practice. Always remember that the experience your patient has with your staff affects their overall perception of your practice.
- Provide useful educational materials to patients.
There’s no better way to increase your communication with patients than to make sure that they have access to credible, current educational material on their condition. In addition to your office pamphlets, you can provide helpful educational information on your website and can refer patients to that information when they call with questions or issues but are not in your office.Information is empowering, particularly on subjects that directly affect or concern us. Patient who are more knowledgeable about their condition are likely to better understand your recommended treatment options at the time of the patient’s visit. You should also provide additional information to the patient after their visit. This can include educational information on prescribed medications or educational materials regarding any procedure you are going to do on the patient. Remember, an educated patient is a better and more compliant patient.
- Communicate with the patient’s family, caregiver, spouse, or children.
We often talk to our patients only to receive a call from a caring and concerned family member who asks questions that were covered in a discussion with the patient. However, the patient was so distracted during their office visit that they didn’t remember the conversation. This is quite common with patients who receive a diagnosis of serious illness. This news is often such a shock that they shut down and don’t hear or remember our advice and recommendations.In situations that may inspire lots of questions from family members or caregivers of the patient, and particularly if you believe that the patient will not be able to recall the information later, you should ask the patient if they would like to include a spouse or other family member in the conversation. You can also provide the patient with a short written summary of your verbal discussion. This process improves your communication and your relationship with the patient and the patient’s family.
Bottom Line: In this era of information overload, short attention spans and non-stop distractions, effective communication is becoming increasingly vital to the success of our practices. Sometimes just talking to the patient for a few minutes before discussing their medical condition, asking a few extra questions, and providing helpful information and educational materials can make all the difference in how patients see their relationship with you and how they talk about you to their friends and loved ones.