Effective Physician-Patient Communication

Effective physician-patient communication and health outcomes are strongly correlated. The connection between them has only recently been studied, with a few studies being performed to assess it. We’ve all experienced physician-patient communication at some point throughout our lives, whether as doctors or, more commonly, as patients. If you’re a physician, you’ve been on both ends of the relationship, and surely you’ve compared how your doctor talks to you when you’re sick to how you deal with your patients. This requires a bit of self-reflection, of course.

It’s fair to say you’ve been to a doctor at some point in your life who, according to a lot of people, is one of the best in his/her specialty, but you just couldn’t connect with him/her. It’s also likely there’s a reason you’ve been going to your family doctor for decades and greet her/him with warmth when you run into them outside the healthcare setting. Many times, good communication can make the difference between a patient’s recovery and their getting worse.

Effective physician-patient communication can be improved through a variety of approaches. For instance, it’s very important to always know your patient’s name, even if you’re busy and care for a dozen people at a time. How would you feel if you ran into your doctor somewhere and they didn’t remember your name? Another important method is eye contact. Eye contact establishes a connection between the doctor and the patient, as well as conveys confidence. Patients who trust their doctor are definitely more likely to follow instructions. 

For patients, it’s very important to feel they’re being listened to. A lot of patients often leave their doctor’s office feeling low, because they think their physician didn’t pay attention to their concerns. It can be easy to forget that patients don’t have even half the knowledge a physician does and can be worried about something minor that can be cleared up with a little explanation. In fact, sometimes it’s even simpler than that. All a patient usually needs is someone to listen for a few minutes, and who better to confide and trust in than their doctor?

It’s both a patient’s right and an effective means of communication to keep the patient well informed of their condition, as well as making the final decision regarding their condition. It’s a physician’s duty to explain all possible options to a patient and not withhold any information, even if they think certain options might not be as rewarding as others. It’s a doctor’s obligation to help, not control, the patient.

Of course, there are obstacles to effective physician-patient communication. A doctor might simply be too busy, even though this is not an excuse. If you’re too busy for all your patients, you’re not really doing them much good. Another is doctor burnout, which can result in a loss of satisfaction from practicing medicine, and a doctor may even start to antagonize their patients. This is an issue that requires in-depth analysis and solutions. Junior doctors might let their emotions get in the way of honest or rational statements. For instance, they might find it difficult to deliver a poor prognosis or may be too eager to make promises when things start looking up.

Some inferior communication skills include poor eye contact, unfriendly welcoming of the patient, interrupted sessions, lack of attention from the doctor, not encouraging the patient to ask questions, and not allowing them to express their concerns. Use of complex medical terminology is also considered poor communication; a patient may feel you’re being arrogant or looking down on them, and medical terms might worry them, because, let’s face it, most medical terminology sounds scary, and you can’t blame a non-medical person for disliking it. 

Effective physician-patient communication and health outcomes are closely tied together for a variety of reasons. For instance, understanding the importance of not missing a dose of a drug or not stopping it too soon may keep the patient compliant. Explaining benign side effects to drugs may also stop them from being afraid and quitting the drugs. A certain antibiotic, for example, may cause a patient’s urine to turn red. Someone who was not informed about this by their doctor may assume they’re developing hematuria and might decide to stop the drug altogether. It’s also important to warn the patient about serious side effects of a drug and to tell them to come back to you if it occurs so you can figure out a better solution for them. This goes both ways, as you need to listen to your patients, too. If you don’t allow your patients time to speak, you might not know they’re allergic to a certain drug, resulting in a reaction that may end in anaphylaxis and death.

If a patient has a non-curable disease, it’s essential to explain to them what to expect. A patient who has systemic lupus, for example, must be warned about serious complications and to visit the hospital immediately if any of them develop. Someone with chronic hepatitis or liver cirrhosis has to understand the importance of following up every few months so that, if hepatocellular carcinoma occurs, it can be diagnosed early and therefore more easily treated. If a doctor simply tells a patient to follow up without explaining why, the patient might simply assume it’s an unnecessary inconvenience.

For a diabetic, effective physician-patient communication can be the difference between living a normal life and having a limb amputated. Some might shy away from explaining the numerous complications of diabetes to patients so they don’t scare them, but in doing so, they’re harming their patients. A patient who is well informed and knows all the terrifying diabetes complications may be upset and a little shocked at first, but will definitely take better care of themselves and will live a long and healthy life. Of course, this is not to say you should scare patients out of their wits to get them to follow orders. It’s important to be honest and to give the patient the full picture without adding or taking anything away from it.

Communication can also decide whether or not a patient alters their lifestyle for the better. Someone who has diabetes won’t stop eating food that worsens the condition because a doctor simply told him/her that it’s bad to do so. A doctor who takes the time to explain to their patients why they should stop certain habits and the impact it’ll have on their lives will succeed in changing their patients’ lives. Some doctors will take the time not just to tell patients why smoking is bad and its health hazards, but also ways to stop. Taking the time to discuss this with a patient who had no idea what to do can make all the difference. It’s important to be there for your patients every step of the way and to show them your office is always open if they need anything. Some patients will see how much their physician cares as an extra motive. This doesn’t mean you should guilt your patient into doing things; just show them their health matters to you and that they’re not only a checkbook.

Poor physician-patient communication can have a negative impact on the physician as well. A patient may assume a doctor who is not great at communicating may lack the personality and leadership skills to guide him or her back to health. After all, a physician is someone most people in a community look up to. A doctor who has a strong character and is a strong leader earns his patients’ trust. If your patients feel you’re lacking in these aspects, they will lose faith in you. This can result in patients simply switching to another physician who may not even be as great a clinician as you, but who makes patients feel comfortable and safe. Patients will always choose a doctor they can trust. Physician leadership training through a leadership course for doctors could help improve your reputation.

It’s always a breaking point when you go to a doctor and feel like they’re shaky or not sure of what they’re saying. A patient can feel this way due to a lack of eye contact, for instance, which is a sign of weakness. Not allowing patients time to ask questions might also make them feel you’re afraid of not being able to answer them. It’s like being in a classroom, basically. As kids, we all looked up to our teachers, especially those who had answers. If you felt like a teacher was dependable, you may have relied on them and even went to them with something personal. Of course, we all remember having teachers who seemed weak, and did we rely on or trust them? Probably not. It’s the same way with physicians and patients, but on a grander scale. A doctor is someone you trust your health with, which is the most valuable thing you have. You’re not just going to trust anyone with it.

Patients may also associate poor communication with a bad bedside manner. A terminal patient knows nothing can be done to save him/her, but will still need comfort. The last thing you need is someone who you feel doesn’t care and treats you like you’re insignificant. People want to feel loved, especially when they’re most vulnerable. This will also matter to family who, due to their busy lives, might not always be able to be there for their loved one; knowing someone who cares deeply is there to make sure their loved one is as comfortable as possible can mean the world to them.

People who sense their doctor doesn’t have time for them will simply find another one. Perhaps a doctor used to find time for them, but, as he got older, he acquired more patients. Don’t let your success as a physician get in the way of your patients’ health or your patient care. What would make you keep going to a doctor who always feels rushed and doesn’t even remember your name? There’s no shortage of doctors, and people may tolerate a few minor mistakes from an inexperienced doctor if it means feeling cared for.

Bad reviews are another effect of poor communication. So, it’s not just losing patients and money; you may even lose your license. A study has shown that patients are less likely to sue doctors they like for malpractice. What do you think makes them like one doctor better than another, even if both are on the same level, clinically? You guessed it: communication.

A few studies on effective physician-patient communication and health outcomes have shown the impact is significant, although it could not be fully and correctly assessed due to a multitude of factors, such as drugs, environment, and other interventions. One study showed that longer visits with physicians allowed for increased patient participation, preventive health, and patient education. It might be that a mother wasn’t planning to vaccinate her child against measles, for instance. She may have never had it and doesn’t know anyone who had it, so she doesn’t understand the full scope of the disease. With a little explanation, she will give her child the recommended vaccines. The same study showed that suboptimal visits result in decreased patient satisfaction, increased patient turnover, and inappropriate prescribing. If patients don’t trust you, why should they follow up with you, and why would they follow your instructions? In fact, if a side effect of a drug arises, they’re more likely to blame you and go see another doctor than consult you to see if this is a common occurrence if they don’t trust or have faith in you.

It is the doctor’s job to ensure his/her communication with patients is effective and productive. A patient is not supposed to know how to break the boundaries between him and his physician. Some patients might be shy, upset, restless, or even angry, and a doctor has to know how to deal with each accordingly. Two doctors might write the same prescription for the same patient with different results, because one of them took the time and effort to care and listen. A diabetic might enter a hypoglycemic coma because he wasn’t informed of the warning signs and how to act, while another may be leading a completely normal life. Effective physician-patient communication can make the difference between two doctors who have the same knowledge and skills.

Two young doctors who just graduated might have completely different career paths. Sure, a massive part of it will rely on effort to learn new skills and acquire more knowledge, but the importance of communication can’t be underestimated. One of them will rise because patients love him/her, and, as a result, he/she could become a famous physician. To those patients, he/she is what a doctor should be: a guardian angel. They are the kind of physician the patient pictured when they were kids. While the other might be in over his/her head with lawsuits, malpractice, and license problems because they caused a patient a problem by not clearly explaining a procedure, or didn’t pay attention when the patient said they were allergic to penicillin.

A doctor is as successful as his/her reputation. You will definitely visit a doctor whom you heard diagnosed someone you know as soon as they walked into the room, but whether or not you’ll keep going to that doctor will depend on how you see him/her. Are they the guardian angel the patient always pictured? Or are they someone who spent ten minutes without letting the patient talk, or even looking them in the eye?