How Well Are Doctors Communicating With Patients Today?
Good communication is an essential part of your child’s asthma care. When doctors do certain things when communicating with parents and patients, a number of things about your care will be improved such as:
- Your asthma concerns will be directly addressed.
- You will be more satisfied with your child’s asthma care.
- Instructions will be better understood
- You will be able to ask questions and voice concerns.
- You will be proactive rather than reactive about your child’s asthma.
- You will have less anxiety about your child’s asthma.
Communicating With Patients – 10 Things Your Diabetes Doctor Should Be Doing
Communication with patients is a learned skill. As such, doctors can do specific things to make you feel comfortable and improve how well you understand your child’s asthma. Examine the following list of specific communication behaviors. How many does your doctor regularly display? The more they utilize in patient care, the better their communication skills are likely to be.
1. Your doctor asks what asthma problems and concerns you are your child are experiencing and then focuses on those issues during your visit. Your doctor is focusing on your main asthma problems and concerns when he/ she:
- Makes direct eye contact with you and speaks directly to you throughout the office visit?
- Encourages you to explain your asthma problems and concerns in detail?
- Discusses your perception of your asthma control and symptoms?
When your doctor asks these things it will help you better communicate your asthma concerns.
2. When communicating with patients, is your doctor an active listener?
Doctors who are more effective at communicating with patients or parents will use a technique called ‘active listening’ to clarify and better understand your asthma problems.By clarifying your asthma problems, they will make sure they correctly understood your asthma concerns. After they understand the problem, they can more effectively explore your asthma problem. Active listening consists of:
- Hearing the problem: Does your doctor appear to pay close attention to what you or your child are saying?
- Interpretation: Does your doctor summarize what was said? This confirms they heard what you were trying to say?
- Evaluation: Does your doctor ask you questions about what you said?
- Respond: Does your doctor verbally express (or use equivalent non verbal cues) that your concerns will be addressed?
3. A good communicator lets you talk.
Most U.S. physicians don’t do a good job of allowing a patient to speak before interrupting. According to most surveys, it takes less than a minute for the average U.S. physician to interrupt. In communicating with patients, a sign that your asthma doctor is a good communicator is that you are able get out everything you want to say before being interrupted.
4. A good communicator summarizes your main points.
Does your doctor periodically summarize information to make sure you are both on the same page? If so the chances are your is an above average when communicating with patients. Statements like “you have been waking up coughing 3 times per week and don’t feel like you can keep up in gym class” are examples of summarizing main points.This gives you the opportunity to make sure your diabetes doctor heard what you were saying and to correct any mistakes.
5. Does your diabetes doctor ask about how your are living with asthma?
Your child’s asthma care involves more than just peak flow values and inhalers. If the social and daily living aspects of your child’s asthma are not addressed, their asthma will not be under optimal control.
6. Does your doctor check for understanding?
Doctors go to school for years and have a tremendous wealth of knowledge, but doctors who are better than their peers at communicating with patients will also check for understanding from their patients. For example, your doctor may ask you to repeat back to them the side effects of a new medicine are or what steps need to be followed in an asthma action plan.
7. Uses non-verbal communication techniques.
To improve communication with patients, non-verbal skills are also essential. When your doctor does this well, you will likely not even notice. However, you will get a sense that your doctor is a poor communicator when non-verbal communication skills are poorly utilized. For example, when your doctor leans toward you while maintaining direct eye contact, they are using their body language to convey concern about what you are saying. Similarly, when your doctor puts a hand on your shoulder they are clearly expressing empathy for your condition. Finally, if your doctor turns their back while talking and bangs away at a computer screen you easily understand communication is not high on their priority list.
What do you think the following say about doctor patient communication? Has this ever happened to you? How does it make you feel?
- Does your doctor sit down at your level and talk with you, or do they just ask questions and type into a computer screen?
- Does your doctor allow pages and other interruptions during your visit?
Non-verbal skills can improve communication with patients or leave a patient feeling like they have not been heard.
8. Seeks your input in developing your asthma treatment plan.
Have you ever been to see a doctor, have them ask you a bunch of question, and then receive a prescription and the doctor is gone? Doctors who do this will also be surprised if you return to see them and the treatment has not had expected results.
Actively involved patients are not only more satisfied, but they also are more successful. This may be because patients who actively participate in the development of a treatment plan are more likely to follow the treatment plan. While it is very easy for your doctor to tell you to eat better, drink less soda, or exercise, it is much more difficult for your doctor to figure out your perspective and adapt your beliefs to an asthma treatment plan. If your doctor takes this extra step, your doctor is certainly more effective than most in communicating with patients. If you are thinking about changing doctors, ask other patients questions about how their doctor formulates a treatment plan with them.
9. Is your doctor empathetic?
Doctors who express empathy or the feeling that they really understand your asthma problems and concerns are much more appreciated by their patients than those who are not able to express empathy. Statements like “It must have been really scary to when your child’ began wheezing” demonstrate that your doctor cares about how asthma affects you. Such statements, even if your doctor has incorrectly understood what happened, show your doctor’s concern of how asthma is affecting you.
10. Persuades rather than tells you what to do.
The decision to follow your doctor’s advice is yours alone, and you are unlikely to do anything just because your doctor tells you to. Doctors who are better at communicating with patients will present plans for diagnosis and treatment as options. The idea is that while your doctor can recommend, the ultimate decision is up to you.
What do you think? Can you think of any other factors that demonstrate a doctor is a good communicator?
I discuss a number of other essential skills and techniques for working with your doctor on my About.com site.
Gordon GH. Defining The Skills Underlying Communication Competence. Seminars In Medical Practice 2002; 21-28.
Maguire P, Pitceathly C. Key Communication Skills And How To Acquire Them. BMJ 2002;325:697–700.