The Journal of the Arkansas Medical Society Med Journal March 2020 Final 2 - Page 8

Cover Story by Casey L. Penn Improving Doctor-Patient Communication H “ ave you ever considered communica- tion to be one of the necessities to being a successful physician? “Most people believe they are ef- fective communicators,” said SVMIC Vice Pres- ident of Medical Practice Services Stephen A. Dickens, JD, FACMPE. “The key is not that you un- derstand what you’re talking about, but that the person you’re talking to understands what you’re trying to tell them.” Whether you are in private practice or an employed physician, there are ways to improve communication and thereby your practice, ac- cording to Dickens. “Physicians are at a disad- vantage when it comes to communicating with patients,” he explained. “You don’t speak the same language as your patients, you’re in a hurry to start because of the many burdens put upon you, and electronic medical records have done nothing to help. “However, you need to understand that ef- fective communication doesn’t take any longer than ineffective communication. In the long run, it saves time. To put it in context, think about a patient who leaves without understanding what they’re supposed to do. It results in phone tag, in- creased frustration for both parties, or, at worst, the patient not getting the care he or she needs.” To help you evaluate and improve doc- tor-patient and staff-patient communication, we visited at length with Dickens, who speaks and advises regularly on the subject. Our con- versation follows. AMS: How can physicians make sure patients understand what they’re telling them? In the exam room, you want to make eye contact, introduce yourself, and call the patient by name, understanding that no matter what you say, most of your communication with the patient comes from body language or tone of voice. 200 • The Journal of the Arkansas Medical Society little rock pediatric clinic's waiting room is inviting and patient focused. Dickens: You must meet patients where they are. When patients enter the clinic, they are like- ly apprehensive, uncertain of what’s expected of them, and concerned about costs and health outcomes. Patients may decide what’s wrong with them before they come in. It’s important that they understand why a physician is doing something – particularly if the physician is con- tradicting their self-diagnosis. You can say things like, “Actually, you don’t have this, this is why, and this is what I think you have.” Patients need to know that you’re engaged and listening. If not, they’ll assume you didn’t care – and that you ignored their concerns. Re- flective listening can help. For instance, you can paraphrase back to the patient what she has told you … “Okay, so you’re dizzier in the evening than you are in the morning?” AMS: What are some other tips for im- proving communication in the exam room? Dickens: Approach conversations from a positive perspective by telling patients what you can do as opposed to what you can’t do. How physicians phrase things is important. Often, they come into the exam room and say, “What can I do for you?” or “What brings you in today?” That’s an ice breaker, and many doctors call it a cognitive test. In other words, they want patients to tell them in their own words what they’ve already told the nurse. It isn’t a bad ques- tion, but there’s a better way to ask it. Instead of asking “What brings you in today,” walk in and say, “I’ve read what you’ve told my nurse Suzy, but I really want to hear from you what’s going on.”