Doctor-Patient Communication: Health Communication Content Curation Project

Verilogue is a company devoted to researching physician-patient dialogue. They produced the attached infographic that provides a numerical breakdown of doctor-patient-caregiver conversations categorized by specialty, appointment type, and gender dynamic. The source points out that patients in appointments regarding chemotherapy and birth control rank as the least engaged in conversations with their doctor. These are such critical appointments; the lack of patient participation is cause for concern. It can be attributed to patients not understanding medicine enough to feel comfortable questioning the doctor, but that should not be a barrier with such personal matters. This data is a great source for healthcare professionals to reference when training about interpersonal communication. There are evident disparities in the quality of communication among medical specialties. The quantitative results of this research emphasize the unequal exchange between doctor and patient.

On the Webpage, PLEASE CLICK "HERE" TO VIEW THE MAIL SURVEY MATERIAL

Patients evaluate hospital staffs’ communication skills by completing the HCAHPS survey. It is comprehensive, inquiring about health professionals’ quality of service, health-related material received by a patient, physical responsiveness of staff, and clarity of medical dialogue. We can see that doctor-patient communication alone is not the whole story. A patient encounters numerous staff members that together create an impression of a healthcare facility. The HCAHPS is gathering raw data of hospitals to give the most objective analysis and score of a facility’s patient communication skills. They look further than the conversations of healthcare professionals to also evaluate the nonverbal communication with patients. Response time when a patient needs assistance is such an important part of nonverbal communication that influences a patient’s experience in the hospital. The effectiveness of a healthcare facility’s communication is examined through a holistic review that focuses on the complete spectrum of interaction.

PLEASE REFER TO "FEEDBACK ON COMMUNICATION STYLE"

Rush Medical Center had to swallow their pride and work tirelessly to reform their patient communication after receiving an unacceptably low HCAHPS score (survey listed above). They bounced back with high improvement rates over the next five years. They developed an effective feedback program that could serve as a model for medical centers around the country. Within the multiple phases of their reform program, hospitalists received one-on-one feedback and suggestions about their patient communication. Hard times caused Rush to deliver the most detailed, personalized feedback about individual doctor-patient communication. This seems extremely labor intensive and expensive, but a health center is only as effective as its ability to communicate. Commentary and feedback catered to individual doctor’s performance is important because it cannot be disregarded like a generic research paper on communication theory. These doctors were given the information they needed to make drastic improvements to their ability to communicate with patients.

PLEASE CLICK ON THE COMPONENTS OF THE MODEL FOR MORE INFO

The Macy Initiative was a project created to improve the interpersonal communication education of medical students. This communication model was developed by NYU School of Medicine to guide doctor-patient conversations. This model points out two important components of the conversation. The requirement to “Elicit and Understand Patient’s Perspective” is unique, but vital, because it holds doctors responsible for asking patients about their expectations for the visit. It is often mistaken that doctors must simply reiterate textbook facts verbatim, but they can have a greater impact by taking time to listen to patients concerns. The “Negotiate and Agree on Plan” component allows an open channel of communication that considers a patient’s desired level of contribution to their health and treatment plans. This model used to educate medical students combines the field of communication’s use of theory based models with a respect for the unique need for patient input in medical decisions.

Dr. Wagman provides an analysis of how to know if doctor-patient communication is effective, especially in his specialty of oncology. Patients should be encouraged to reiterate the information they are being told to check for understanding. The most important point Dr. Wagman makes in this video is that patients sometimes ask questions that reveal they did not properly understand a previous conversation. It is a red flag that signals the doctor to rethink their delivery of the information. Other sources are interested in the duration and breakdown of dialogue or the simple act of asking any questions, but Dr. Wagman encourages doctors to take communication to the next level. Rather than just answering questions, he wants doctors to address a patient’s motivations behind their question. This level of critical analysis can stimulate flow of conversation and clear up a large amounts of uncertainty between doctor and patient.

PLEASE REFER TO "INEQUALITY IN PATIENT COMMUNICATION" AND "RECOMMENDATIONS FOR THE OBSTETRICIAN-GYNECOLOGIST"

A committee opinion released by the American College of Obstetricians and Gynecologists cites research about cultural barriers in health communication. The perspective of patients with different cultural backgrounds is hard for individual doctors to understand, but research shows that overall African American patients honestly feel the inequality in their doctor-patient exchanges. Identification of these types of concerns is essential to providing quality care. Many studies simply agree that doctor-patient communication requires reform, but the underlying issues need more investigation. Acknowledging the ethnicity barrier has lead to this nationally recognized committee recommending cultural competency training to all OB/GYN specialists. This shows that data and research can gain powerful support that leads to the implementation of change. Cultural competency will help healthcare professionals communicate and better understand patients’ perspectives.

PLEASE REFER TO "5. KEEP IT SIMPLE" AND "6. TELL THE TRUTH"

In The Journal of the American Osteopathic Association, Travaline et al. outline their own model for effective doctor-patient communication that includes unique insight into what audience doctors need to develop their language around. The high percentage of Americans without a high school diploma is an important factor when we consider word choice and the explanation of technical medical terminology. This demographic of Americans represents an important culture that a doctor with a high education level could fail to recognize. Additionally, Travaline et al. provide an important counter to that point by stressing doctors must be honest, and not oversimplify content to the point that it loses meaning. It is crucial that doctors still make statements of prognosis and treatment clear. The researchers present doctors with the challenge to balance their language within an appropriate reading level while delivering unambiguous medical information; this leads to effective patient communication.

PLEASE REFER TO "ATUL GROVER: USE OTHER MEMBERS OF THE TEAM"

In the Wall Street Journal, renowned physician Dr. Atul Grover stresses integrated patient care by suggesting doctors rely on the greater medical team at their disposal. If all the health professionals of an institution have the patient’s best interest in mind, then a consensus about the proper course of treatment can be reached. This means communication can branch out of the traditional doctor-patient restrictions to create a health network including pharmacists, nurses, physicians’ assistant, and surgeons. This dispersal of responsibility and professional collaboration would provide consistent information to patients and ensure effective communication from health professionals to patients. With advances in technology, this idea is more practical than ever because of the speed and access to electronic communication. Health systems could implement Dr. Grover’s idea to ensure patients receive the best communication from all of their healthcare professions.

PLEASE REFER TO SEGMENT 0:00-3:27

Professor Dunn addresses the patient’s responsibilities in conversations about their health, a rarely discussed topic. Patients discomfort and embarrassment with medical matters often causes them to avoid the most important concerns until the end of their appointment, which makes it hard for doctors to respond because there is no time to really address the issue. Communication is a two way street, and patients can encourage this by preparing questions ahead of time. This idea from Professor Dunn seems obvious, but patients may not necessarily take this extra step if health professionals, the people they are communicating with, did not encourage it. This testimonial is important because it shows that doctors are interested in equal exchange of conversation and even have some proposed solutions. Patients should feel more comfortable opening up in this kind of inviting environment.