As a physician, one of your most underrated skills is your ability to effectively and compassionately communicate with patients. While most physicians have valuable experience from years of clinical work, few receive any formal communication training after medical school.
The current healthcare environment is also rapidly changing, requiring new skills from providers. Clinical work today demands increasing productivity while offering less time with each patient. Meanwhile, EHR adoption poses new challenges for busy physicians juggling computer data entry with genuine patient interactions.
These factors beg the question – How can physicians communicate with patients more effectively in a clinical setting?
Here are four approaches to physician-patient communication that are designed to improve patient satisfaction, reduce the likelihood of litigation, and improve patient outcomes.
1. The Partnership Model
The partnership model is a simple concept used in countless care settings. The basic idea is that patients should be full-fledged partners of the health care delivery team.
As a provider, partnering with patients means using a participatory style of conversation where you and the patient spend an equal amount of time talking. The goal of this approach is to increase patient involvement in their health care through negotiation and consensus-building.
2. AIDET Patient Communication
Developed by Studer Group, AIDET is a framework to help healthcare professionals communicate with patients in a way that decreases patient anxiety, increases compliance and improves clinical outcomes.
The framework uses five simple steps:
- Acknowledge – Greet the patient by name. Make eye contact, smile, and acknowledge family for friends in the room.
- Introduce – Introduce yourself with your name, skill set, professional certification, and experience.
- Duration – Give an accurate time expectation for tests, physician arrival, and identify next steps. When this is not possible, give a time in which you will update the patient on progress.
- Explanation – Explain step-by-step what to expect next, answer questions, and let the patient know how to contact you, such as a nurse call button.
- Thank you – Thanks the patient and/or daily. You might express gratitude to them for choosing your hospital or for their communication and cooperation. Thank family members for being there to support the patient.
It’s important to remember that AIDET is not a script, but rather a simple, consistent way to incorporate fundamental patient communication elements into every interaction.
3. The RESPECT Model
The RESPECT Model is widely used to promote physicians’ awareness of their own cultural biases and to develop physicians’ rapport with patients from different cultural backgrounds.
Rapport
- Connect on a social level
- See the patient’s point of view
- Consciously attempt to suspend judgement
- Recognize and avoid making assumptions
Empathy
- Remember that the patient has come to you for help
- Seek out and understand the patient’s rationale for her behavior or illnesses
- Verbally acknowledge and legitimize the patient’s feelings
Support
- Ask about and try to understand barriers to care and compliance
- Help the patient overcome barriers
- Involve family members if appropriate
- Reassure the patient you are and will be available to help
Partnership
- Be flexible with regard to issues of control
- Negotiate roles when necessary
- Stress that you will be working together to address medical problems
Explanations
- Check often for understanding
- Use verbal clarification techniques
Cultural competence
- Respect the patient and their culture and beliefs
- Understand that the patient’s view of you may be defined by ethnic or cultural stereotypes
- Be aware of your own biases and preconceptions
- Know your limitations in addressing medical issues across cultures
- Understand your personal style and recognize when it may not be working with a given patient
Trust
- Self-disclosure may be an issues for some patients who are not accustomed to Western medical approaches
- Take the necessary time and consciously work to establish trust
To learn more about the RESPECT Model, see Toward culturally competent care: A toolbox for teaching communication strategies (Allen and Welch 2002).
If the steps above seem overwhelming, remember that each of these models uses similar principles. As with all skills, effective patient communication requires practice.
Most doctors will want to attend a training to successfully integrate these approaches. Research shows that the most effective communication skills programs are typically full-day trainings that start with learners’ goals and needs, and focus on applying learnings to clinical practice.