Five tools good doctors use to communicate with patients

Reading Time: 5 minutes

Doctor_stethoscopeDoctor-patient miscommunication is the most common cause of complaints and failure of communication is an important cause of medical errors. But empathy is another neglected attribute that is often missing during a doctor-patient interaction and this needs to be highlighted as empathy is crucial to establish trust that will form the basis for a good doctor-patient relationship.

Develop empathy

Empathy is vital especially for doctors handling patients with cancers, debilitating chronic diseases, protracted diseases, disease with poor prognosis and uncertain outcomes, depression or anxiety and the like. It has been proven that empathy shown by doctors have resulted in greater patient satisfaction, better outcomes, trusting relationships and a reduction in the number of malpractice suits and errors.

Perhaps I can give you a perspective of the importance of both communication and empaty in dealing with my own patients. Communication also means perfecting the art of non-verbal communication to allow us to adjust our responses to suit the situation at hand.

Improve non-verbal communication

I remember an encounter with a patient many years ago when I was working as a physician in one of the district hospitals in Malaysia. She was in her early thirties and came regularly to see me, each time smiling and complaining of vague abdominal pain. I could not find a cause and wondered why she kept on coming to see me, each time looking seemingly happy and quite unconcerned that we could not reach a definite diagnosis.

As a physician, your observational skills are important. This is part of non-verbal communication. I sensed that she could have underlying depression and was masking it from me probably because of shyness or discomfort in discussing her marital problems with me. Perhaps the monthly sessions with me were sort of therapeutic even though the problem remained unsolved.

After several visits, I persuaded her to get herself admitted mainly to ascertain the diagnosis. I encouraged her to bring along her husband. She readily agreed. During the interview in the ward, she broke down and cried for the first time and the husband was taken aback obviously oblivious of his wife’s unhappiness. To cut the long story short, she improved after the truth was unraveled. They both made up and the abdominal pain did not recur.

Had I dismissed her complaints or fail to observe her non-verbal messages or did not show empathy for her predicament, she would have suffered quietly with no solution in sight. So it is important that as doctors we develop and enhance our observational skills and curiosity to always seek for solutions for conditions we seemingly cannot explain. Our empathy for our patients will encourage us to effortlessly help find the root cause of the problems thereby building a trusting relationship and be assured of a good outcome in the end.

Build a rapport

Courtesy, respectfulness and responsiveness are vital for a beneficial interaction with your patient.

A doctor’s communication and interpersonal skills are imperative if he or she wishes to gather the most amount of information from his or her patient in order to get an accurate diagnosis, discuss the management plan, prognosis and at the same time observe the reaction of the patient after being told the news. There are patients who do not absorb fully what you tell them. Either they do not understand or they do not care.

Your job is to make sure they understand what they are suffering from and that you have the ability to guide them through the critical period. You have to show that you care and that they can trust you. Do not be clinical and state “You have cancer” or you have only three months to live and expect them to thank you for the news. Some news may have to be given gently. Nothing is worse than releasing a barrage of information to an unprepared patient. You might scare them off. Worse still, they may think you are being too brutal and therefore uncaring.

I always feel that your attire, your professionalism, warmth, gentility, composure, tone, bedside manners are important ingredients in order for you to build a trusting relationship with your patients. Of course you must be knowledgeable, honest, humble and approachable.

Attentive listening, empathy and genuine concern for the patient will endear you to your patients. They have to trust you in order to adhere to your instructions and management plan.

Do not assume your patients understand you

Do not assume the patient understand what you tell them all the time. I remember prescribing patient with dulcolax suppositories for his constipation only to learn later from him that the treatment did not work and that he had terrible discomfort in trying to swallow the suppositories! There was also this surgeon who instructed the nurse to give “mist pot cit” (mist potassium citrate) to a patient with urinary problems only to discover later that the nurse gave him a pot to sit on! There are many examples of such breakdown in communication.

Always talk in a language the patient can understand and this include avoiding medical jargon as far as possible. Build a trusting relationship with him if you want him to follow your advice and comply with treatment. Do not be put off if he asks a zillion questions. It is his right to ask and your job to explain and provide the answers.

Remember these days patients may have more information than you do. Sometimes they may be testing you. If you fail to impress them or provide wrong or evasive answers, you will lose the patient and the whole town will soon learn about it. So always be prepared, knowledgeable and honest. If patients default treatment, you must share part of the blame as you have obviously failed to convince him enough, discounting those who wish to seek alternative remedies. Some doctors think they are great communicators and get enraged when their patients do not heed their advice.

Show genuine respect

Empathy and good doctor-patient communication are vital for you to get the right diagnosis, provide the right treatment and get the desired responses from your patient. It is all about trust and patience. The patient need to trust you and you need to be patient. Listen carefully and emphatically to his problems without showing signs of impatience, boredom and inattention. If he finds or thinks that you are not interested or see you looking at your watch or sending text messages etc. the communication is over and you will lose him.

You must show genuine respect for you patients; do not be condescending or patronising. Manage the patient’s expectations no matter how difficult or challenging they are. These days, patients are demanding. That is not to say they are being difficult. It is just that they themselves are knowledgeable especially having access to the internet. They get naturally worried if their doctors know less than they do.

So besides good bedside manners, great technical skills, sound clinical acumen, we must never forget to display professionalism, decorum, empathy and communication skills in dealing with our patients. Only then can you enjoy the company of patients instead of expensive lawyers.

Tan Sri Dato Ismail Merican
Tan Sri Dato Ismail Merican

Prof. Tan Sri Dato’ Seri Dr. Hj. Mohd. Ismail Merican is Pro-Chancellor & Chairman of MAHSA University, was Senior Consultant Physician & Senior Consultant Hepatologist, Hospital Kuala Lumpur & Hospital Selayang and currently serves as a doctor at Prince Court Medical Center, Kuala Lumpur, specialising on hepatology and internal medicine.

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Doctor-patient miscommunication is the most common cause of complaints and failure of communication is an important cause of medical errors. But empathy is another neglected attribute that is often missing during a doctor-patient interaction and this needs to be highlighted as empathy is crucial to establish trust that will form the basis for a good doctor-patient relationship. Develop empathy Empathy is vital especially for doctors handling patients with cancers, debilitating chronic diseases, protracted diseases, disease with poor prognosis and uncertain outcomes, depression or anxiety and the like. It has been proven that empathy shown by doctors have resulted in greater...

Reading Time: 5 minutes

Doctor_stethoscopeDoctor-patient miscommunication is the most common cause of complaints and failure of communication is an important cause of medical errors. But empathy is another neglected attribute that is often missing during a doctor-patient interaction and this needs to be highlighted as empathy is crucial to establish trust that will form the basis for a good doctor-patient relationship.

Develop empathy

Empathy is vital especially for doctors handling patients with cancers, debilitating chronic diseases, protracted diseases, disease with poor prognosis and uncertain outcomes, depression or anxiety and the like. It has been proven that empathy shown by doctors have resulted in greater patient satisfaction, better outcomes, trusting relationships and a reduction in the number of malpractice suits and errors.

Perhaps I can give you a perspective of the importance of both communication and empaty in dealing with my own patients. Communication also means perfecting the art of non-verbal communication to allow us to adjust our responses to suit the situation at hand.

Improve non-verbal communication

I remember an encounter with a patient many years ago when I was working as a physician in one of the district hospitals in Malaysia. She was in her early thirties and came regularly to see me, each time smiling and complaining of vague abdominal pain. I could not find a cause and wondered why she kept on coming to see me, each time looking seemingly happy and quite unconcerned that we could not reach a definite diagnosis.

As a physician, your observational skills are important. This is part of non-verbal communication. I sensed that she could have underlying depression and was masking it from me probably because of shyness or discomfort in discussing her marital problems with me. Perhaps the monthly sessions with me were sort of therapeutic even though the problem remained unsolved.

After several visits, I persuaded her to get herself admitted mainly to ascertain the diagnosis. I encouraged her to bring along her husband. She readily agreed. During the interview in the ward, she broke down and cried for the first time and the husband was taken aback obviously oblivious of his wife’s unhappiness. To cut the long story short, she improved after the truth was unraveled. They both made up and the abdominal pain did not recur.

Had I dismissed her complaints or fail to observe her non-verbal messages or did not show empathy for her predicament, she would have suffered quietly with no solution in sight. So it is important that as doctors we develop and enhance our observational skills and curiosity to always seek for solutions for conditions we seemingly cannot explain. Our empathy for our patients will encourage us to effortlessly help find the root cause of the problems thereby building a trusting relationship and be assured of a good outcome in the end.

Build a rapport

Courtesy, respectfulness and responsiveness are vital for a beneficial interaction with your patient.

A doctor’s communication and interpersonal skills are imperative if he or she wishes to gather the most amount of information from his or her patient in order to get an accurate diagnosis, discuss the management plan, prognosis and at the same time observe the reaction of the patient after being told the news. There are patients who do not absorb fully what you tell them. Either they do not understand or they do not care.

Your job is to make sure they understand what they are suffering from and that you have the ability to guide them through the critical period. You have to show that you care and that they can trust you. Do not be clinical and state “You have cancer” or you have only three months to live and expect them to thank you for the news. Some news may have to be given gently. Nothing is worse than releasing a barrage of information to an unprepared patient. You might scare them off. Worse still, they may think you are being too brutal and therefore uncaring.

I always feel that your attire, your professionalism, warmth, gentility, composure, tone, bedside manners are important ingredients in order for you to build a trusting relationship with your patients. Of course you must be knowledgeable, honest, humble and approachable.

Attentive listening, empathy and genuine concern for the patient will endear you to your patients. They have to trust you in order to adhere to your instructions and management plan.

Do not assume your patients understand you

Do not assume the patient understand what you tell them all the time. I remember prescribing patient with dulcolax suppositories for his constipation only to learn later from him that the treatment did not work and that he had terrible discomfort in trying to swallow the suppositories! There was also this surgeon who instructed the nurse to give “mist pot cit” (mist potassium citrate) to a patient with urinary problems only to discover later that the nurse gave him a pot to sit on! There are many examples of such breakdown in communication.

Always talk in a language the patient can understand and this include avoiding medical jargon as far as possible. Build a trusting relationship with him if you want him to follow your advice and comply with treatment. Do not be put off if he asks a zillion questions. It is his right to ask and your job to explain and provide the answers.

Remember these days patients may have more information than you do. Sometimes they may be testing you. If you fail to impress them or provide wrong or evasive answers, you will lose the patient and the whole town will soon learn about it. So always be prepared, knowledgeable and honest. If patients default treatment, you must share part of the blame as you have obviously failed to convince him enough, discounting those who wish to seek alternative remedies. Some doctors think they are great communicators and get enraged when their patients do not heed their advice.

Show genuine respect

Empathy and good doctor-patient communication are vital for you to get the right diagnosis, provide the right treatment and get the desired responses from your patient. It is all about trust and patience. The patient need to trust you and you need to be patient. Listen carefully and emphatically to his problems without showing signs of impatience, boredom and inattention. If he finds or thinks that you are not interested or see you looking at your watch or sending text messages etc. the communication is over and you will lose him.

You must show genuine respect for you patients; do not be condescending or patronising. Manage the patient’s expectations no matter how difficult or challenging they are. These days, patients are demanding. That is not to say they are being difficult. It is just that they themselves are knowledgeable especially having access to the internet. They get naturally worried if their doctors know less than they do.

So besides good bedside manners, great technical skills, sound clinical acumen, we must never forget to display professionalism, decorum, empathy and communication skills in dealing with our patients. Only then can you enjoy the company of patients instead of expensive lawyers.

Tan Sri Dato Ismail Merican
Tan Sri Dato Ismail Merican

Prof. Tan Sri Dato’ Seri Dr. Hj. Mohd. Ismail Merican is Pro-Chancellor & Chairman of MAHSA University, was Senior Consultant Physician & Senior Consultant Hepatologist, Hospital Kuala Lumpur & Hospital Selayang and currently serves as a doctor at Prince Court Medical Center, Kuala Lumpur, specialising on hepatology and internal medicine.

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