1. Communication with Patients, Families, and Coworkers4
Communication with Patients, Families, and Coworkers

2. Learning Outcomes 4.1 Identify elements of the communication circle.
4.2 Understand and define the developmental stages of the life cycle.
4.3 Give examples of positive and negative communication.

3. Learning Outcomes (cont.)
4.4 List ways to improve listening and interpersonal skills.
4.5 Explain the difference between assertiveness and aggressiveness.
4.6 Give examples of effective communication strategies with patients in special circumstances.

4. Learning Outcomes (cont.)
4.7 Discuss ways to establish positive communication with coworkers and management.
4.8 Describe how the office policy and procedures manual is used as a communication tool in the medical office.

5. Learning Outcomes (cont.)
4.9 Describe community resources and how they enhance the services provided by your office.
4.10 Explain how stress relates to communication and identify strategies to reduce stress.

6. Introduction Medical assistants must Recognize human behaviors
Communicate effectively, with professionalism and diplomacy
Recognize obstacles that affect therapeutic communication

7. Communicating with Patients and Families
You are the key communicator between the physician and patient
Your interaction sets the tone for the office visit
Developing strong communication skills is just as important as mastering administrative and clinical skills
Communication will influence how comfortable the
patient feels in your practice.

8. Communicating with Patients and Families (cont.)
Customer service
Most important part of communication
Two points fundamental to customer service
The patient comes first
Patient needs are satisfied
Patients are #1!

9. Communicating with Patients and Families (cont.)
Examples of customer service
Telephone techniques
Writing or responding to telephone messages
Explaining procedures to patients
Assisting with billing issues
Creating a warm and reassuring environment

10. Apply Your Knowledge Good!
What are the two key parts of customer service?
ANSWER: The two fundamental parts of customer service are that the patient comes first and you must satisfy patient needs.
Good!

11. The Communication Circle
The communication circle involves an exchange of messages through verbal and nonverbal means.

12. Communication Process
Patients often believe that health care has become impersonal due to
Technological advances
Managed care organizations
Maintain a patient-centered approach

13. Apply Your Knowledge
What are the three elements of the communication circle?
ANSWER: The three elements of the communication circle are the message, source, and receiver.
RIGHT!

14. Human Behavior: Stages of the Life Cycle
Understanding growth and development enhances communication skills
Physical development
Psychological and emotional growth
Guidelines for communication based on developmental stage
Infant
Toddler
Preschooler
School age
Adolescence
Young, middle, old adult

15. Maslow’s Hierarchy of Human Needs
Self-Actualization
Esteem Needs
Love/Belonging Needs
Safety Needs
Physiological Needs
Deficiency (Basic) Needs

16. Apply Your Knowledge Good Answer!
You can communicate with all people in the same way. Is this statement true or false, and why?
ANSWER: The statement is false. Not all people are at the same place on Maslow’s hierarchy of human needs. To communicate effectively with a person, you need to understand what he or she is deficient in. For example, you would use different communication styles when talking to a homeless person who may have psychological and safety needs than when talking to an elderly person who is lonely and depressed due to the recent loss of his or her spouse.
Good Answer!

17. Types of Communication
Positive or negative
Verbal or non-verbal
Written (Chapter 7)

18. Positive Verbal Communication
Communication promotes the patient’s comfort and well-being
Set the stage for positive communication
Encourage patients to ask questions
Speak slowly and clearly

19. Negative Verbal Communication
Curb negative communication habits
Mumbling
Speaking brusquely
Avoiding eye contact
Interrupting patients as they speak
Rushing explanations
Forgetting common courtesies
Showing boredom
Treating the patient impersonally

20. Non-Verbal Communication
Facial expression
Eye contact
Posture
Open
Closed
Touch
Personal space
In many instances, people’s body language conveys their true feelings, even when their words may say otherwise.

21. Apply Your Knowledge
YEA!
Mr. Garcia comes to the desk to check in and asks if he will be seen on time. The receptionist continues with her paperwork, points to the sign-in sheet, and tells Mr. Garcia: “Just sign in. The doctor will be with you when he can.” Explain why this is an example of negative communication.
ANSWER: This is an example of negative communication because the clerk
Did not stop what he or she was doing – was not friendly or attentive
Did not greet Mr. Garcia or make eye contact with him
Did not give a satisfactory answer to Mr. Garcia’s question
Did not make sure Mr. Garcia understood when he would be seen

22. Improving Communication Skills
Listening skills
Passive listening
Active listening
Improve listening skills
Prepare to listen
Relax and listen attentively
Maintain eye contact
Maintain personal space
Think before you respond
Provide feedback

23. Improving Communication Skills (cont.)
Interpersonal skills
Warmth and friendliness
Empathy
Respect
Genuineness
Openness
Consideration and sensitivity

24. Therapeutic Communication
The ability to communicate with patients
In terms they can understand
So they feel at ease and comfortable
The ability to communicate with other members of the health-care team
Technical terms
Appropriate to the health-care setting

25. Therapeutic Communication (cont.)
Involves
Silence
Accepting
Giving recognition
Offering self
Giving a broad opening
Offering general leads
Making observations
Encouraging communication
Mirroring
Reflecting
Focusing
Exploring
Clarifying
Summarizing

26. Ineffective Therapeutic Communication
Roadblocks
Reassuring
Giving approval
Disapproving
Agreeing/ disagreeing
Advising
Probing
Defending
Requesting an explanation
Minimizing feelings
Making stereotyped comments

27. Defense Mechanisms Unconscious, designed to protect self
Patients may display
Compensation
Denial
Displacement
Dissociation
Identification
Introjection
Projection

28. Assertiveness Skills
Assertive – people who are firm and stand by principles while still showing respect for others
Requires
Openness
Honesty
Directness
Aggressive – people who try to impose their position on others or try to manipulate them

29. Apply Your Knowledge Good Answer!
What is the difference between being aggressive and being assertive?
ANSWER: Assertiveness means standing by your principles while showing respect for others. You trust your instincts, feelings, and opinions and act on them. An aggressive person tries to impose his or her own position on others or tries to manipulate them. He or she is bossy, may be quarrelsome, and does not consider others’ feelings, needs, thoughts, ideas, or opinions.
Good
Answer!

30. Communication – Anxious Patient
Can interfere with communication process
May not listen well or pay attention to what you are saying
Observe for
Tense appearance
Increased blood pressure and breathing
Sweaty palms
Irritability and agitation

31. Communication: – Angry Patient
Goal is to help the patient express anger constructively
Steps in communicating with an angry patient
Recognize anger and its cause
Remain calm and demonstrate respect
Focus on physical and medical needs
Maintain adequate personal space
Do not take anger personally
Ask patient to be specific concerning cause
Present your point of view
Avoid breakdown of communication
Leave if you feel physically threatened

32. Communication – Patients from Other Cultures
Each patient has his or her own behaviors, traditions, and values
Strive to understand and be tolerant
Stereotyping
Negative statement about specific traits of a group applied to an entire population
Generalization
Statement about common trends within a group

33. Communication – Other Cultures (cont.)
Attitudes about health care
Beliefs about causes of illness
Symptoms and what they mean
Treatment expectations
Language barriers

34. Communication – Patients with Visual Impairment
Use large-print materials
Use adequate lighting in all areas
Use a normal speaking voice
Talk directly and honestly
Do not talk down to the patient
Preserve the patient’s dignity

35. Communication – Patients with Hearing Impairment
Find a quiet area to talk
Minimize background noise
Position yourself close to and facing the patient
Speak slowly
Remember that elderly patients lose the ability to hear high-pitched sounds first
Verify understanding
Use written material
Speak clearly but do not shout

36. Communication – Mentally or Emotionally Disturbed
Determine what level of communication the patient can understand
Suggestions
Remain calm if the patient becomes agitated or confused
Avoid raising your voice
Avoid appearing impatient

37. Communication – Elderly Patients
Be respectful
Do not talk down to elderly persons
Touch – communicates caring

38. Communication – Terminally Ill Patients
Often under extreme stress, so offer support and empathy
Kubler-Ross’s Stages of Dying
Denial
Anger
Bargaining
Depression
Acceptance

39. Communication – Young Patients and Their Parents
Recognize and accept their fear and anxiety
Explain all procedures
Use praise
Do not tell children that a procedure will not hurt if it will, or you will lose their trust
Reassuring and keeping parents calm will also help the child relax

40. Communication – Patients with AIDS/HIV
Stigma of disease
Guilt
Anger
Depression
You must have accurate information about the disease and the risks involved to answer the patient’s questions
Patients need human contact and to be treated with dignity

41. Communication – Patient’s Family and Friends
Provide emotional support to the patient
Acknowledge family members and friends
Keep them informed about patient’s progress
Remember to protect patient confidentiality
Ask the patient what information can be given to family or friends

42. Apply Your Knowledge Right!
What can you do to promote communication with someone who is visually impaired?
ANSWER: Use large-print materials, adequate lighting in all areas, and a normal speaking voice. Talk directly and honestly, but do not talk down to the patient; preserve the patient’s dignity.
Right!

43. Communication with Coworkers
Develop rapport with coworkers
Rules for the medical office
Use proper channels
Have a proper attitude
Plan an appropriate time for communication

44. Communicating with Management
Keep supervisor informed
Ask questions
Minimize interruptions
Show initiative

45. Dealing with Conflict Do not gossip
Do not jump to conclusions
Set boundaries to limit undesirable behavior
Do not “feed into” others’ negative attitudes
Be personable and supportive
Refrain from passing judgments

46. Apply Your Knowledge Bravo!
What strategies can you use to avoid conflict in the workplace?
ANSWER: You can use the following strategies to avoid conflict in the workplace:
Do not “feed into” others’ negative attitudes
Be personable and supportive
Refrain from passing judgments
Do not gossip
Do not jump to conclusions
Bravo!

47. Policy and Procedures Manual
Key written communication tool
Policies
Dictate the day-to-day workings of an office
Describe chain of command
Procedures
Detailed instructions for specific procedures

48. Policies Office purposes Salary evaluations Rules and regulations
Job descriptions
Office hours
Dress code
Insurance
Vacation and sick leave
Salary evaluations
Maintenance of equipment
Mailings
Bookkeeping
Scheduling appointments
OSHA

49. Procedures Purpose of test, clinical application, and usefulness
Specimen required and collection method
Special patient preparations or restrictions
Reagents, standards, controls, and media used
Instrumentation
Calibration and schedules
Step-by-step directions

50. Community Resources
Good customer service is founded on providing or researching services to assist in attaining the goal of patient health and well-being
Discuss with patient’s physician before referring patient
Resources
Alcoholics Anonymous
Shelters
Hospice
Mental health services
Meals on Wheels
PASSPORT
Easter Seals
State agencies
Support groups

51. Other Resources Reference laboratories Insurance companies
Office equipment suppliers
Maintenance companies

52. Apply Your Knowledge Right!
What is the difference between policies and procedures?
ANSWER: Policies dictate the day-to-day workings of an office and usually describe the chain of command. Procedures are the detailed instructions for specific procedures.
Right!

53. Personnel Management Employee Other administrative tasks Hiring
Relations
Benefits
Performance
Other administrative tasks
Hiring
Training
Compensation

54. Personnel Management (cont.)
Employee orientation
Stress competencies
Teamwork
Policies/procedures
Cross-training

55. Personnel Management (cont.)
Successful hiring
Find the most qualified person for the job
Scrutinize and check references carefully
Have a salary range
Discuss policies and procedures early
Train properly and re-train

56. Apply Your Knowledge
What is employee orientation essential to? What should be stressed during employee orientation?
ANSWER: Personnel management
ANSWER: Competencies of teamwork, policies and procedures, and cross-training
Good Answers!

57. Managing Stress Stress can be a barrier to communication
Stress can occur
Due to a feeling of being under pressure
As a reaction to anger, frustration, or change in routine
Stress is normal
Motivating
More productive

58. Managing Stress (cont.)
Ongoing stress
Overwhelming
Physical effects
Reducing stress
Consider your strengths and limitations
Be realistic about commitments both at work and in your private life
Techniques to reduce stress

59. Apply Your Knowledge Right!
List three things you can do to relieve stress.
ANSWER: Any of the following can help you reduce stress:
Exercise regularly
Eat a balanced diet
Get enough sleep
Set realistic goals
Be organized
Change what you have control over
Keep focused
Identify sources of conflict
Maintain a sense of humor
Try not to overreact
Right!

60. Burnout
Burnout is the end result of prolonged periods of stress without relief
Type A personality
Highly driven, perfectionist-type person
More susceptible to burnout
Type B personality
More relaxed, calm, “laid back”
Less prone to burnout

61. Burnout (cont.) Stages to burnout Honeymoon Awakening Brownout
Full-scale burnout
Phoenix phenomenon

62. Preventing Burnout Take time to rest and relax
Be realistic about job expectations, your aspirations, and your goals
Create a balance in life

63. Apply Your Knowledge Good Job! What are the phases of burnout?
ANSWER: The phases of burnout are
Honeymoon
Awakening
Brownout
Full-scale burnout
Phoenix phenomenon
Good Job!

64. In Summary
4.1 The communication circle involves a message being sent, a source, and a receiver that responds. 4.2 It is important for the medical assistant to understand the development of the life cycle as it will assist in communication skills with patients. 4.3 Communication that promotes comfort and well being is considered positive communication. Medical assistants may not be aware of some of the signs of negative communication they display.

65. In Summary (cont.)
4.4 Listening and other interpersonal skills can be improved by becoming more involved in the communication process. 4.5 Assertive medical professionals trust their instincts. Aggressive medical professionals try to impose their positions through manipulation techniques. 4.6 Learning about the special needs of patients and polishing your communication skills will help you become an effective communicator.

66. In Summary (cont.)
4.7 The quality of communication you have with your coworkers and your supervisor greatly influences the development of a positive or negative work climate. 4.8 The policy and procedure manual is a key communication tool. 4.9 Community resources are available in your local area to patients who may need additional outside resources Stress can be good or bad. However, it is how we handle stress that makes the difference.

67. End of Chapter 4
Often during life-altering experiences, patients and their loved ones need a shoulder to cry on or someone to comfort them. It is important for them to know support is there.
—Lindsey D. Fisher (The Healers Art)