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.”
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