Medical science does not stand still, it becomes more accurate, but a doctor of the “classical” type will retain his place in medicine: the one whose vocation is better human communication skills.
Clinicians belong to a social group being one of the fundamental links of the health care system. The problems of the ability to establish contact with the patient, the ability to subordinate their interests to the interests of the patient come to the fore. These skills are considered as an indicator of providers’ professionalism. They significantly affect the patient and can undermine or strengthen the doctor’s authority over the patient not only during treatment, but also during various studies.
At the same time, healthcare providers are becoming more and more technically equipped. However, we should not forget that scientific and technological progress is also associated with some difficulties and changes in the system of doctor-patient relations. In the conditions of the modernization of medicine, laboratory research, hardware and computer diagnostics, direct communication between the doctor and the patient is blurred. In addition, the mechanism of establishing trust is lost.
However, people tend to trust people, so we have some great news for you!
There are various ways of building trust that we are going to share with you in this article. Enjoy!
Step 1.Know the Relationship Options in Medicine
Modern healthcare organizations distinguish 3 main types of patient-doctor communications. Here we want you to have a quick glance at these types to understand the basis of problems arising out of them.
#1. Paternalism (“fatherhood” type)
The main decision-maker is a doctor.
This type of communication is very controversial due to the fact that patients are autonomous. If we talk about a person with a terminal disease, the paternalistic model will be the following: the patient is sometimes not told the true nature of his condition.
According to those who advocate paternalism, a patient may be too overwhelmed by his health outcomes to make rational decisions about his treatment. Moreover, patient experience and knowledge don’t suffice for making changes to a treatment plan.
The argument against the paternalistic model is very obvious: the provider can’t withhold relevant information from and make significant decisions for the patient. It is morally unacceptable to do so.
#2. Consumerism
The main decision-maker is the patient.
“Сonsumerism is an unwelcome thorn in the medical flesh.” Little S., 1981
The main problem with this model is considering a patient as a service consumer, and a doctor as a service supplier. Consumerists think that what a person needs equates with their highest interests, but we know that it can’t be true. This argument is particularly salient in the mental health sphere, where a “consumer“ can completely interfere with his own course of treatment.
Such patients believe that their decision-making about their own health is sufficient. It seems to them that the information received in the public domain makes him a doctor’s equal.
In fact, this is no more than a substitution of concepts: a person with fragmentary (and this is how it happens in most cases) knowledge is not the same as an informed person.
Obviously, only healthcare professionals can determine benefits or harm, and provide better care to patients.
#3. Partnership (“cooperation” type)
Decisions are made jointly and to the degree of patient participation that he prefers.
This type is considered to be the most progressive and fruitful option of medical interaction, helping to build rapport between a clinician and a patient.
The specifics of this effective communication are influenced by the increase in medical awareness of the population. The general “competence” of the population in the field of medicine facilitates mutual understanding, ensures that patients are aware of the need for certain procedures, operations and other medical prescriptions.
But on the other hand, this often generates distrust and a negligent attitude to the advice of a doctor (especially a young one), doubt about the correctness of the treatment prescribed by the doctor, the desire and inclination to self-treatment or to turn to alternative medicine. The formation and maintenance of trusting relationships between patients and doctors is extremely critical for the proper functioning of patient care systems. This is because they depend on emotional interpersonal interactions.
Step 2. Learn the Principles of Successful Communication with Patients
Empirical data confirm the importance of forming trusting relationships in the context of public health system activities. In particular, patients with a low initial level of trust in doctors consistently demonstrate less satisfaction with treatment and less desire to follow medical advice. In addition, they tend to report that the necessary or requested medical service has not been delivered to their attending physicians.
What should be the basis of the doctor-patient relationship?
Trust. A “smart” patient is a person who trusts a specialist, and trust should be reciprocated. It is ideal for the doctor to establish partnership relations with his ward in the future.
According to the Topdoctors, patient satisfaction is often undermined by the following problems.
We are sure that you’ve noticed: the stumbling block is the inability to listen and hear the patient.
Don’t interrupt the patient!
Doctors often interrupt a patient’s open story after an average of 18 seconds, the most common reasons for interrupting being clarifications and closed questions.
It’s very helpful to listen to the patient’s perspective because:
Patients speak for an average of 60 seconds after an open question from a doctor
The longer the doctor does not interrupt the patient, the more complaints and problems the patient reports
The sequence of complaints submitted does not coincide with the clinical significance.
Active listening structures consultations, reducing undetected complaints and problems. Also, it helps to collect a large amount of patient information and as a result leads to better patient outcomes and quality improvement.
The example of screening
Screening is a useful way to establish contact during the first visit. Moreover, it’s widely used in mental health systems, because this method helps to build trackable patients’ progress.
Let’s look at the following example:
Doctor (D): So, you’ve been feeling sick and dizzy lately. What else is bothering you?
Patient (P): I also get tired very quickly and irritability has appeared.
D: So, you are also experiencing severe fatigue and irritability. Maybe something else?
P: I once had anemia and I had a similar condition.
D: So, as I understand it, you have headaches and dizziness, as well as fatigue, irritability and some weakness, and you are afraid that you may have anemia. Something else?
P: No, perhaps that’s all.
As you can see, the most important aspects of screening are asking open questions, not interrupting a patient, and making him recall all meaningful facts about his well-being. This professional communication and behaviour usually results in building trust and confidential relationships with patients.
Joint decision-making
A partnership model of communication should be your goal. The systematic review has highlighted the core principles of developing the model with the help of a joint decision-making process.
It includes:
- Sharing your thoughts, ideas and possible problems with patients
- Offering options, not direct statements
- Calling for the patient to share their opinions
- Determining the level of the patient’s participation in decision-making in accordance with his desire
- Determining patient preferences
- Verifying that all the patient’s problems have been resolved.
Step 3. Demonstrate Nonverbal Behavior
Knowing the differences in verbal and nonverbal communication is a must for professional caregivers and clinicians.
These types of communication are different in:
Nonverbal behavior for a medical worker is influenced by many factors.
Position: Sitting/standing, straight, or relaxed
Personal space is the distance between the doctor and the patient. Keep in mind that the location of those communicating on opposite sides of the table creates the effect of intimidation, competition or barrier
Touching: handshake, patting, physical contact during examination
Body movements: hand gestures, nodding, foot movement
Facial expression: raised eyebrows, frowning, smiling, crying
Eye behavior: eye contact, gaze, surface gaze
Voice: volume, speed, intonation, pauses, speech errors
Physical parameters: gender, race, physique, clothing
Environment: lighting, location of objects, air temperature and so on.
In order to control patient safety, a physician must be able to read the patient’s body language. This will simplify the relationship with the patient, allow you to establish a trusting relationship with him, save time, prevent conflicts and directly contribute to increasing the number of follow-ups.
Step 4. Make Friends with Innovations and Electronic Health Software
The pandemic has accelerated the penetration of digital technologies in the sphere of health.
The term “digital healthcare” itself implies many entities, among which:
- Communications (remote diagnostics, distance learning, patient communities and medical associations, practice management software)
- Feedback systems (personalized monitoring, mobile applications for maintaining health, SMS consultations)
- Technological tools (portable hospital, self-monitoring systems, visualization of care, bioprinting, etc.)
All these innovations are commonly discussed among your potential patients on the Internet, making your presence in social media an obligatory task.
Not to mention, social networks in medicine help to compare and improve your skills, work and services by sharing helpful and useful information. They also give feedback about the work of a colleague or about the service provided.
Why do you need it?
Let’s imagine a flawless picture.
Your clinic (or you personally) is well-known in social media, you have a constant flow of new patients. Now your task is to meet all their expectations, provide top service and reduce no-shows.
The logical decision is to use electronic health software that can solve a bunch of your problems:
- Patient scheduling
- Telephony
- Medical billing
- CRM and so on.
People tend to trust each other, as we mentioned at the beginning.
Despite universal digitalization, people will always look for and trust the doctor who listens attentively, tries to understand the nature of the problem, and explains it to the patient, rather than just sitting in front of a computer without looking at them.
The use of EHR systems gives you the main advantage that really matters: a medical professional spends more time caring about how a patient feels, not how to fill out another report.
