1. The Patient-Doctor Relationship Sonia Sehgal, M.D. Course Director CFI Associate Clinical Professor Department of Internal Medicine UC Irvine Program in Geriatrics This work was supported by a grant From the Donald W. Reynolds Foundation

2. Objectives Understand why patient-doctor communication is key to a successful relationship Learn basic communication strategies for an improved patient-doctor experience

3. The Patient-Doctor Relationship Class exercise: –Tell me about your most memorable positive experience with a physician (when you were a patient)

4. The Patient-Doctor Relationship Class exercise: –Tell me your most negative experience

5. The Patient-Doctor Relationship What does being a doctor mean to you?

6. Communication Patient-Doctor communication is important –Improved satisfaction –Improved compliance –Improved decision making –Better health outcomes –Decreased malpractice claims

7. Communication Skills Essential for diagnosing and treating illness Essential in establishing a meaningful patient-doctor relationship Facilitates educating and counseling patients

8. Communication Information gathered must be: –Objective –Accurate –Precise

9. A model patient- doctor relationship Trust Compassion Open and honest communication Respect

10. Why is Doctor-Patient Communication Unique? Trust –Patients on the first visit share their most personal information to someone they have never met before –They look to you for guidance when making critical health care decisions

11. Why is Doctor-Patient Communication Unique? Trust –Within minutes of meeting, patients are often required to disrobe for a physical examination and are placed in a vulnerable situation

12. Communication Who will you be communicating with? –Patients –Families –Colleagues –Other health professionals

13. Patient Communication Patients who feel at ease are more likely to tell you their reason for coming to the doctor’s office Be yourself! Show true interest

14. The Physician’s Duties Respects the patient Ensures privacy and trust of confidential information Demonstrates genuine concern for patient’s health Limits distraction to provide patient undivided attention

15. Respect Introduce yourself –Patient –Family –Caregiver

16. Respect Explain your role and goal for the interaction

17. Respect If appropriate shake hands Always address the patient as: Mr., Mrs., Ms, etc.

18. Empathy To understand a person’s experience Different than sympathy Requires –Active listening –Interest in patient’s experience

19. Objectivity Removing your own beliefs and values Avoid judgmental attitudes –IV Drug Abuse –Education –Socioeconomic status –Language/Cultural differences –Ageism

20. Active Listening Skills Respect the patient as a whole person, not a diseased body Use confirmatory statements: –“Yes” –“Tell me more about that” Allow the person to tell their whole story without unnecessary interruptions

21. Active Listening Don’t be afraid of silence

22. Body Language Examination room configuration Sitting/Standing Eye level Eye contact –Note taking Posture Hurried speech

23. Body Language Patients notice more than you think –2/3 of communication is non- verbal Appropriate use of touch

24. Patient-Doctor Communication: Key Points Ask about expectations, feelings and concerns Show concern for comfort and modesty Give an opportunity to express feelings and concerns Encourage patients to ask questions

25. Communication skills can be developed with practice, patience and a willingness to learn