Interrupting patients and other physician faux-pas
Interrupting patients and other physician faux-pas
Expert advice on avoiding common mistakes
In an ideal world, patients would attend courses on how to communicate their needs and concerns to doctors and how to make the most of a medical visit.
"The first thing I would teach them is to say, 'How are you today, Doctor?' No one ever asks doctors how they're doing," says a wistful Robin DiMatteo, PhD, professor of psychology at the University of California-Riverside and a long-time researcher of the doctor-patient relationship.
"It'd be nice to know someone cared. It would be nice if the patient smiled. Or said please or thank you."
But sometimes patients are too distressed, preoccupied, or just downright difficult to worry about the doctors' feelings. So the burden for fixing the blunders at the heart of patient-doctor encounters falls on the physician.
Even well-meaning physicians fall into common traps that can lead to poor communication. Here are some frequent failures, as identified by DiMatteo:
1. Interrupting patients.
Faced with time pressures, physicians may try to hurry along the dialogue about what is troubling the patient. "A very common problem is interrupting the patient before the patient has had a chance to tell the story," says DiMatteo. "Studies show that the average physician interrupts a patient within about 18 seconds of starting to talk."
And allowing the patient to speak fully may avoid another communications problem: the patient who mentions a major health concern or symptom just as the doctor reaches for the doorknob to leave.
2. Thinking about the past or future while the patient is talking.
It's hard to walk into an exam room and completely set aside other issues that are taking place with staff or other patients. But it must be done to address the current patient's needs.
"When interacting with the patient, even physicians who are good at communication skills are thinking about what just happened or what they have to do next," says DiMatteo. "If they're really focused on what's happening now, they can more fully listen to what's happening with the patient.
"Taking a moment or two to really listen - it's amazing how much mileage you get from that," she says. "That's one of the major complaints patients have, that physicians don't really listen to them."
3. Thinking of patients as a disease or condition rather than as a person.
The Hypertensive in exam room No. 2. The diabetic in exam room No. 1. For expediency, it's tempting to identify patients with this shorthand. But in the long-run it shortchanges them to refer to them as "a container of a disease" rather than as people, says DiMatteo. Instead, all patients should be addressed by name at all times.
4. Failing to show patients you are listening.
Communication seminars teach doctors basic ways to show patients they are listening. The advice includes these commonsense concepts:
- Make eye contact.
- Don't write or look at the chart while the patient is talking.
- Nod and repeat back key points the patient has made as a "feedback loop."
5. Failing to give patients written instructions.
Sometimes patients don't follow the treatment advice simply because they don't remember it. "An easy way to deal with that is to say it and write it down in [legible] handwriting," says DiMatteo.
But don't make the reverse mistake, either, of simply handing the patient a brochure or written note without going over the recommendation and why it's important, she says.
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