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Patients don't
care how much you know until they know how much
you care.
Today’s patients want to play an active
role in their medical treatment. How can you help
to encourage their participation and improve your
doctor-patient relationship ? The answer is simple
– learn to communicate with them ! Even
if you are very busy, it’s possible to be
an effective communicator -- you simply need to
communicate "smarter" by making better
use of the time you've got. Communication with
your patient is an art – what is often referred
to as bedside manner
For most doctors, good communication is a skill
like playing a musical instrument, which needs
to be learned, and then practiced repeatedly to
be perfected. The best communicators have an open
mind, a receptive ear and an empathetic heart.
Their good bedside manner is perfected through
practice, experience and feedback from patients
and other doctors. For these doctors, bedside
manner comes naturally, and if you know a doctor
with good communication skills, try to adopt him
as your mentor and copy him !
You can also work on improving your interpersonal
skills by following these tips
Remember your manners. Patients
are more likely to follow your advice if they
have a good relationship with you. How you enter
a room is very important. Walk in with a smile,
shake the patient's hand, call the patient by
name (first name or surname, whichever the patient
prefers), and sit down. Make it a point to always
remember the patient’s name – and
if you have a bad memory, instruct your staff
to prompt you ! You can also help to put the patient
at ease by starting off with a simple “
How can I help you ? “
Don't appear rushed, even if you are.
Patients get irritated when their doctors appear
hurried. Make each patient feel that they are
in the center of the universe – focus all
your attention on him. Sitting down and talking
is far more effective than talking while standing
up – and takes just a few seconds more !
Keep conversations on track. Helping
patients stay on track is key to increasing efficiency
and maximizing the value of the time you have
with them. You need to guide them so they don’t
wander off on a tangent !
Listen without interrupting.
While your tendency may be to ask your patients
a lot of questions up front, you'll get more information
and save time in the long run by actively listening
to the patient without interrupting. Studies have
shown that the patient normally speaks for an
average of 18 seconds before the doctor interrupts.
However, if you let them speak for three to four
minutes, they tell you 90 percent of what's wrong
with them
Organize your interviews. To
make the most of your interview time, structure
your patient interview. For example, if you want
to explore the psychological aspects of a patient's
complaint you may want to try the "BATHE
technique" , which divides the patient interview
into the following components
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• Background ("Tell me what has been
happening.");
• Affect ("How do you feel about that?");
• Trouble ("What's upsetting you most
about it?");
• Handling ("How are you handling the
situation?");
• Empathy ("That must have been difficult.").
Teach your patients how to communicate with you.
Since communication is a 2-way process, it’s
very useful to teach your patients how to discuss
their concerns with you . You can teach them to
use the simple formula, PREPARE, so they learn
how to communicate with you.
P = Plan ( what they want to discuss)
RE = Report ( what they have experienced and what
they feel about it)
P = Participate ( so it is a 2-way discussion)
A = Agree ( make a joint decision)
RE = Repeat ( so you can ensure they have understood
correctly).
Use computers creatively. You
can use e-mail to answer patients' questions and
avoid getting tied up in lengthy telephone conversations.
Educate your staff. Communication
isn't just a doctor-patient issue. Your nurses
and clinic staff also represent you to your patients
.To strengthen the staff-patient relationship,
hold staff training sessions on patient communication.
Do the unexpected. Keep in contact
with your patients by routinely calling two or
three of them each day – they will treasure
this gesture.
Be sensitive. The vulnerability
of the patient is something that doctors can forget
too easily. Patients are frequently anxious, unaware
of their diagnosis, afraid of cancer or death,
worried about pain, and scared about the future.
Sensitivity is vital in all your dealings with
them.
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Good communication with worried relatives is also
a necessity. Anxiety and grief sometimes manifest
themselves as anger. Often, when relatives complain
about the treatment a patient has received, their
distress could have been alleviated by talking
to them and explaining things coherently and honestly.
All of us have our own preferred communication
style, depending upon our personality. Analytical
doctors focus on facts and figures, while emotional
doctors focus on feelings. You need to look at
yourself objectively, so you can determine what
your preferred style of communication is. There
is no right or wrong style – it’s
just important that you be aware of what your
preferences are – and your weak points as
well, so you can work on them ! Communication
is a two-way street, and for communication to
be effective, you need to attune your style to
the patient’s style . Patients have different
personalities and communication styles, and you
should be able to adapt your style according to
the patient’s needs. You can become an expert
on doing this if you learn NLP (Neuro Linguistic
Programming) which teaches you how to mirror your
patient’s behaviour, so you can mold their
behaviour effectively.
Just like doctors, patients too have styles they
prefer, depending upon their own personality.
Some are emotional, and communicate through feelings.
They respond to stories of other patients you
have treated successfully. Analytical patients
communicate objectively with logic and rational
thinking. They need facts and figures and data,
and are interested in your success rates and statistics.
Scholarly patients need references and papers,
and will respond to books and articles which support
your recommendations. Socialisers are name-droppers,
who are likely to be very influenced by who your
other patients are. Pictures of you with famous
personalities will impress then – as will
your framed medical certificates and diplomas.
Doctors who can communicate well with their patients
have happier patients; busier practices; greater
income; and higher self-esteem. This is why learning
how to improve your communication skills can be
one of the most important investments of your
time and energy. Communication is more than just
words. Psychologists estimate that only 7% of
any message is the spoken word; 38 % is voice
quality ( tone, tempo, intonation); and 55% is
body language. This means that most of what we
communicate is non-verbal, and you need to be
aware of your non-verbal communication cues –
and those of your patient as well, so you can
respond to them.
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Since you communicate 55 percent of the time without
ever saying a word, you ought to be paying attention
to what your nonverbal signals are saying to patients.
If you think you're simply too busy for a lesson
in nonverbal communication, take heart: If you
can spell "SOFTEN," you can begin to
perfect your nonverbal signals right now.
S is for smile. A smile helps
set patients at ease and generates positive feelings
about you and your practice. This, in turn, breaks
down barriers so you can uncover issues more quickly
and openly.
O is for open posture. Open posture,
which means no crossed legs, arms or hands, says
you are approachable and willing to interact.
Arms drawn together across your chest, on the
other hand, can be intimidating or even condescending
to patients
F is for forward lean. A slight
forward lean toward the speaking party says, "I'm
trying to get closer because I really want to
hear what you have to say."
T is for touch. As you introduce
yourself, shake your patient's hand in a warm
and friendly manner. In addition to the nonverbal
message the handshake sends, you will learn a
lot about the patient's psychological state. Is
the hand warm, cold, jittery, sweaty? All are
clues that may save you time.
E is for eye contact. Eye contact is
probably the most important nonverbal communicator
after smiling. If you maintain eye contact with
your patients 85 percent of the time, you will
be branded as an expert communicator and physician
in the patient's view. Eye contact conveys that
you are paying attention to the individual, not
being distracted by the chart or your notes or
something else on your mind
N is for nod. As your patient
speaks, nod occasionally. This simply means that
you are listening and understand, not that you
necessarily agree. Your nodding helps the patient
move forward with complaints, rather than hesitating
because he or she feels uncertain whether you
are listening.
Remember that the single most important criterion
by which patients judge you as a physician is
the way you interact with them. It is therefore
vital that you develop your understanding of your
own communication style and adjust that style
to meet the needs of various patients. If you
include your patients as fully informed partners
in their care, they'll pay you back by sticking
with you through thick and thin. And as an added
bonus, you'll discover more satisfaction in your
work, renewed motivation and increased productivity.
As with everything, the best way to develop a
great bedside manner is to practise. By ensuring
that you try and put every patient at ease and
alleviate their anxieties, you will find your
communication skills and natural empathy rise
automatically. And when your patients smile at
you and appreciate the way that you have treated
them, their gratitude gives you a warm glow and
reminds you why you went into medicine in the
first place !
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