Improving Physician Communication With Patients: It’s the Personal Touch
Tuesday, August 17 2010
Effective communication is critical, particularly in the health care setting. It is an important component of high-quality care and helps achieve better outcomes. It is estimated that as much as 50% of substandard care is related directly or indirectly to physicians’ communication with patients. And patients sense it; poor communication scores are leading contributors to poor overall satisfaction scores.
Building better relationships with patients means overcoming some verbal and non-verbal behaviors that impede real communication. These behaviors are so ingrained, and the actions in which they are associated are so simple, that it may be surprising to some doctors that they have hurdles to surmount and that it might take some thought and practice to change.
And yet, the bottom line is that the changes really aren’t that daunting. In a way, it is going back to basics on interpersonal skills. We all fall into personality types, and doctors are no different. So here are some examples and reminders of verbal and non-verbal communications with patients:
Our first example may be called Dr. Cross. This otherwise talented physician is found rounding on a patient. She sits on a window seat, remembering she needs to get down to the patient’s level. She is making good eye contact, but each time the patient speaks to answer or ask a question, the doctor crosses her arms. So while she may be listening, her body language says, “I am not open to hearing you.” This is a sign to the patient to shut up. Dr. Cross needs to open up her arms when the patient speaks.
Second up is Dr. Keepaway. This talented surgeon comes into the patient’s room, stands at the foot of the bed and talks to the patient’s foot, which he is going to be operating on tomorrow. He tells the foot that he is the doctor who helped it when it first came into the hospital, and now he is getting ready to fix it in surgery. All the while, there is a live patient who is trying to catch the doctor’s gaze. Dr. Keepaway needs to sit at the patient’s level, make eye contact and give the patient a gentle touch. This will build trust, show empathy and communicate to the patient that this doctor is a human being who is there to make this patient’s life better.
A close cousin to Dr. Keepaway is Dr. Dashby. Not only does this physician not get close, she is barely in the same Zip code, leaning in from the hallway and loudly speaking into the patient’s room (while reading from a chart) for a moment, then dashing off to the next room. It is unfortunate that our physicians are forced to be more productive in order to generate income, as it leaves them with little time to spend in direct conversations with their patients. The result in one recent study showed that physicians spend less than one minute per day on average inside the room of a patient in the intensive-care unit.
Stop and think about how patients feel when the person leading the care team doesn’t have time for them. I realize that the physician has many competing demands, but a priority must be placed on going into each patient’s room, introducing him- or herself if it’s a first visit, establishing eye contact and spending at least one minute to make a human connection. The doctor should ask the patient about his family and what he likes to do in times when he is not facing a health crisis, and share some personal details as well.
Bringing some warmth to the conversation can pay off in the mind of a patient – then the doctor is more than just a clinician. She is the doctor whose child just got back from soccer camp or who likes to read mysteries.
Doctors need to practice these behaviors. Knowing that they are limited on time, they need to find out how to make that short visit more meaningful by connecting with the patient through verbal and non-verbal communication.
Health care leaders need to support the communication needs of patients and physicians by using technology (video, bedside computers, CDs), physician extenders, nursing staff, patient self-management tools, patient navigators and patient advocates. They need to bring effective communication to the top of the to-do list, and work with physicians, patients and employees to find ways to support effective communication.
Physicians need the support, and patients deserve it