Physician-Patient Communication

Back to Basics: Could Improved Patient-Provider Communications be the Remedy Healthcare Needs?

Dealing with an illness or injury is overwhelming for patients and families, who must learn all they can about an unfamiliar condition, make treatment decisions, manage medications, and more, all while stressed with the change in health status.

My son Zachary was 17 when diagnosed with a terminal brain tumor. It was heart-wrenching and often beyond words. As his primary caregiver, it also was a two-year crash-course on how to be an engaged, effective member of a medical team.

As you know, studies have shown that effective communication between the patient and physician leads to more appropriate medical decisions, better adherence to treatment plans and better health outcomes.

Man with nurseConversely, research has found that patients less involved in their care are more likely to experience a medical error in diagnosis or treatment plans and have poor care coordination.

Good patient-provider communications are key but achieving them is often easier said than done. Digital reporting systems like EHRs and increasingly pressed schedules are making it harder to have the kinds of conversations with patients and caregivers that so many physicians long for.

So how can physicians help their patients be more engaged?

Here are 13 tips to improve patient-provider communications and encourage patient engagement:

  1. EHRs can make it hard to document findings while remaining focused on the patient and maintaining eye contact. If it’s too difficult to enter data on your computer while focusing on your patient, use a scribe to take notes.
  2. Give patients the time they need during appointments to ask questions. Welcome questions, don’t be quick to dismiss a patient’s concerns and don’t rush them. Let your patients tell their whole story, knowing that 90 percent of the diagnostic process is the patient’s story. Of course, your knowledge and experience is incredibly important but nobody knows what the patient is feeling and experiencing better than the patient.
  3. Be open to patients who bring in information they found on the internet or heard from a friend. You never know – your patient may have found something that could benefit their health. Discouraging this type of engagement discourages their involvement.
  4. Be sure patients understand what you are saying by using as simple terms as possible and diagrams/models as needed. Ask them to repeat the synopsis of their diagnosis and treatment options and your instructions back to you so you can be sure they understand what you said.
  5. Encourage patients to use a notebook to take notes during appointments and to write down symptoms and side effects at home. Encourage patients to share this information with other medical professionals caring for them.
  6. Allow patients to record your conversations so they can listen at home as often as needed.
  7. Give patients a printed copy of the appointment’s notes. Ask them to read your notes and let you know about any discrepancies.
  8. Encourage patients to keep a folder with all of their important medical documents, including test results and reports, clinical trial data and information from specialists such as nutritionists and physical therapists. Encourage patients to share this information with other members of their medical team.
  9. When referring patients to a specialist, be sure the patient understands exactly why they need to see a specialist. Ask them to write down the reason for the referral and your main concerns so the patient is prepared for an effective conversation with their new provider.
  10. Make sure patients clearly understand when and how to take each prescribed medication. Ask them specifically how they are going to manage a complicated medication routine that requires taking multiple medications throughout the day. If needed, work with your patients to help them set up a system for organizing medications and for reminding themselves to take each medication on time.
  11. Ask patients if financial issues are keeping them from picking up prescriptions. If so, work with them to help them figure out how to get financial assistance and/or find less costly alternatives.
  12. Follow up with test results in a timely manner. Set up a system for reviewing test results so you don’t become one of the 1/3 of doctors who report missing test result alerts that lead to a delay in treatment,
  13. Review all of your written instructional materials to make sure you have clearly described follow up care including all the tiny details. Since you are so familiar with your instructions, have a third party read your paperwork and make suggestions for how to make the instructions more easily understood and followed. For instance, if an instruction says to call you with excessive bleeding, describe what you mean by excessive. If you want the patient to put ice on an injured body part, give specific instructions for how long each icing session should last and how many times per day it should be done.

Working together, not separately

This might seem like a long list, but each tip on its own can amount to just a minute or two of work – often less than that! It was a great privilege to work alongside Zachary’s caring, inspiring medical team, even though I wished I would have had the honor of knowing them under entirely different circumstances. As we move forward in today’s increasingly complex healthcare systems, let us not forget that often simple, clear patient-provider communications can make the difference between help and harm. What if better listening is what doctors ordered for themselves?

Editor’s note: ZaggoCare offers a guide for patients and caregivers, “Managing Your Role as Patient or Caregiver.” The guide is available here and offers important advice for navigating the healthcare system as either patient or caregiver and tips for staying organized and involved. We encourage you to share this guide with your patients and families.  

 

3 Comments

  • Mauvareen Beverley says:

    I think the article is great,I would just add, being cultural competent inclusive of English speaking patients should be included as a requirement for the communication dialogue.
    From past experience, I found that it is important to ask whether a patient has a pill box, particular if they are taking multiple medications several time per day.

  • Heidi says:

    Thanks for this incredibly helpful information. These guidelines seem especially important when doctors are dealing with patients with particular demographics — research has shown that, on average, doctors spend less time and attention dealing with patients in “lower status” groups (immigrants, certain ethnicities, elderly, women… which, in essence, is an enormous swath of the population). The vast majority of these instances are subconscious, so equipping doctors with an understanding of the issue is a great first step.

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