Patient Communication: Practical Strategies for Better Interactions
These five strategies can help you create positive and compassionate patient interactions without adding significant time to the visit.
Fam Pract Manag. 2022 Mar-Apr;29(2):12-16.
Author disclosures: no relevant financial relationships.
Article Sections
- Introduction
- WHY COMMUNICATION MATTERS
- 1. MAKE A POSITIVE CONNECTION WITH THE PATIENT
- 2. DEMONSTRATE ACTIVE LISTENING
- 3. ESTABLISH A SHARED AGENDA
- 4. USE OPEN-ENDED QUESTIONS AND REFLECTIVE STATEMENTS
- 5. SOLIDIFY THE RELATIONSHIP WITH CLEAR EXPLANATIONS
- WHAT ABOUT TIME CONSTRAINTS?
- AN IMPROVED PATIENT VIGNETTE
- START WITH SMALL CHANGES
- References
It has been a busy day in clinic, and your 10th patient of the morning is roomed 30 minutes late. The reason given for the visit is “preventive health.” When you enter the exam room, you introduce yourself and confirm the patient is there for a preventive check-up. Then you ask about health behaviors and screenings, do an exam, and make a plan for testing and immunizations. As you are finishing up the visit, the patient says, “But we never discussed my concerns. I'm having this wrist pain and hand numbness, which have been bothering me a lot. And I keep getting headaches. I'm having one right now, and it's terrible. And my knees are giving out on me a lot, and I'm wondering what you think I should do.” Feeling exasperated, you explain that you don't have time to address these complaints and the patient should follow up at a later date because you have other patients waiting. The patient agrees and leaves, but later gives you a poor review and switches to another practice because “My concerns weren't listened to.”
WHY COMMUNICATION MATTERS
- Abstract
- WHY COMMUNICATION MATTERS
- 1. MAKE A POSITIVE CONNECTION WITH THE PATIENT
- 2. DEMONSTRATE ACTIVE LISTENING
- 3. ESTABLISH A SHARED AGENDA
- 4. USE OPEN-ENDED QUESTIONS AND REFLECTIVE STATEMENTS
- 5. SOLIDIFY THE RELATIONSHIP WITH CLEAR EXPLANATIONS
- WHAT ABOUT TIME CONSTRAINTS?
- AN IMPROVED PATIENT VIGNETTE
- START WITH SMALL CHANGES
- References
A positive patient experience is the result of multiple factors before, during, and after the patient encounter, but chief among them is effective doctor-patient communication. When patients and physicians communicate well, outcomes are better,1 in part because patients are more engaged in their health care. Patients who take an active role in their health can confidently bring up concerns and make lifestyle changes.2
Physicians are constantly being evaluated as communicators — through online ratings, post-visit surveys, etc. Although patient satisfaction scores can push us to improve, they may also add performance pressures if we lose sight of the true goal, which is not to improve “scores” but to build trust.3
This article describes how we can improve communication with our patients without pushing ourselves toward more burnout. Because time constraints are the primary concern for most physicians, we have chosen to focus on five strategies that create positive and compassionate interactions without adding significantly to the time with the patient.
KEY POINTS
When patients and physicians communicate well, outcomes are better, and patients are engaged in their health care.
Making a non-medical “connection” with the patient at the beginning of the encounter takes 1–2 minutes but can improve the patient's perception of the interaction.
Agenda-setting, open-ended questions, reflective statements, and visit summaries are strategies that can improve communication without
References
show all references1. Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ. 1995;152(9):1423–1433....
2. Von Korff M, Gruman J, Schaefer J, Curry SJ, Wagner EH. Collaborative management of chronic illness. Ann Intern Med. 1997;127(12):1097–1102.
3. Morris J, Hotko B, Bates M. The CG CAHPS Handbook: A Guide to Improve Patient Experience and Clinical Outcomes. Studer Group and Fire Starter Publishing; 2015.
4. Mauksch LB, Dugdale DC, Dodson S, Epstein R. Relationship, communication, and efficiency in the medical encounter: creating a clinical model from a literature review. Arch Intern Med. 2008;168(13):1387–1395.
5. Beckman HB, Frankel RM. The effect of physician behavior on the collection of data. Ann Intern Med. 1984;101(5):692–696.
6. Heritage J, Robinson JD, Elliott MN, Beckett M, Wilkes M. Reducing patients’ unmet concerns in primary care: the difference one word can make. J Gen Intern Med. 2007;22(10):1429–1433.
7. Saad Riegels N, Asher E, Cartright JR, et al. Listening beyond auscultating: a quality initiative to improve communication scores in the Hospital Consumer Assessment of Health Care Practitioners and Systems survey. Perm J. 2018;22:16–187.
8. Pollak KI, Alexander SC, Tulsky JA, et al. Physician empathy and listening: associations with patient satisfaction and autonomy. J Am Board Fam Med. 2011;24(6):665–672.
9. Ha Dinh TT, Bonner A, Clark R, Ramsbotham J, Hines S. The effectiveness of the teach-back method on adherence and self-management in health education for people with chronic disease: a systematic review. JBI Database System Rev Implement Rep. 2016;14(1):210–247.
10. Cape J. Consultation length, patient-estimated consultation length, and satisfaction with the consultation. Br J Gen Pract. 2002;52(485):1004–1006.
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