{"id":17062,"date":"2017-10-22T09:00:00","date_gmt":"2017-10-22T14:00:00","guid":{"rendered":"https:\/\/www.zocdoc.com\/about\/?p=17062"},"modified":"2023-10-30T14:12:47","modified_gmt":"2023-10-30T19:12:47","slug":"solving-the-patient-physician-communications-dilemma","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/resources\/blog\/article\/solving-the-patient-physician-communications-dilemma\/","title":{"rendered":"Solving the Patient-Physician Communications Dilemma"},"content":{"rendered":"

When psychologist Dominick Frosch<\/a> first moved to Palo Alto several years ago, one of his first priorities was to establish himself with a new primary care physician. Frosch has Type 1 diabetes, and having a rapport with a doctor to help manage his chronic condition was crucial. But when Frosch walked out of the exam room, he realized he hadn\u2019t really met a new provider at all\u2014at least, not in the way he\u2019d imagined it.<\/p>\n

\u201cHe had his back turned to me the entire time,\u201d Frosch says. \u201cThat was the last time I saw that particular doctor.\u201d<\/p>\n

What Frosch experienced is not uncommon. As tablets begin to take the place of charts and a physician\u2019s attention is diverted to screens, patients are beginning to feel like a third wheel. The time they do have to express their concerns is growing increasingly compressed, making them feel rushed or judged when they come armed with questions.<\/p>\n

For Frosch, the shaky stake of patient-physician communications is more than just a personal gripe. A senior scientist with the Palo Alto Medical Foundation Research Institute, he\u2019s led studies on the problems caregivers encounter in establishing a patient dialogue and how to fix them.<\/p>\n

\u201cThere\u2019s growing evidence communications is the central factor in producing beneficial outcomes,\u201d Frosch says. \u201cAnd more needs to be done.\u201d<\/p>\n

For decades, medical school curriculums put patient communications at low priority.<\/strong> It was a skill that physicians were expected to develop independently and on the job. The problem? \u201cIt\u2019s not something they naturally know out of the box,\u201d Frosch says. \u201cFormalized training is really valuable.\u201d<\/p>\n

While some schools have increased their attention on communications strategies\u2014sometimes called \u201cdoctoring programs\u201d\u2014it\u2019s not every institution, and consequently a number of physicians are released into the wild every year without learning proven techniques on how to both talk and listen. Electronic records have put up another barrier, with physicians busy typing and reviewing data on a screen instead of being attentive to the patient on the exam table.<\/p>\n

For patients, the experience is magnified:<\/strong> feeling doctors are rushed for time, they hesitate to ask too many questions. If the challenge a doctor\u2019s findings, they might be fearful they\u2019ll be labeled a \u201cdifficult\u201d patient and receive lower-quality care in the future. With both sides feeling compromised before the appointment even begins, it\u2019s little wonder that crucial information can be left out.<\/p>\n

Harlan Krumholz<\/a>, M.D., a cardiologist and health care researcher at Yale University, believes that the first step to improving the dialogue is to approach the patient with the idea that the physician is here to help resolve a problem. \u201cGetting to know the individual and learning what their preferences are will help guide you to the most appropriate method of communicating,\u201d he says. \u201cIt\u2019s not a one-size-fits-all approach.\u201d<\/p>\n

Some patients, Krumholz says, may have poured over internet research<\/a> about a given condition and can have a productive conversation without being spoon-fed details; others may have only a passing understanding and need further explanation. \u201cYou need to meet the patient where they are,\u201d he says. \u201cYou can\u2019t just assume they\u2019ll know what it is you\u2019re talking about.\u201d<\/p>\n

That belief can stem from \u201cDoctor Google\u201d concept, where it\u2019s imagined that every patient comes in armed with a base understanding of things. \u201cThere is the notion of a more empowered, activated patient, but you can make a mistake buying into that model,\u201d Frosch says.<\/p>\n

Related: How Physicians are Coping with Self-Diagnosis in the Information Age<\/a><\/span><\/p>\n

Once you\u2019ve gauged how much information a patient has and how much he or she needs, making the most of the allotted time is key. Research<\/a> has shown that pulling up a chair to a bed\u2014if a patient is hospitalized\u2014can make visits seem longer<\/a> because the physician seems more engaged. Looking at patients and reacting<\/a> to their expressions and body language is also key to increased satisfaction with a visit. No one wants to feel like their digital record is of more value to a doctor than actually being in the room.<\/p>\n

But a productive visit isn\u2019t solely in the hands of the physician. According to Frosch, a physician looking to improve their patient dialogue will let them know how they can do their part. \u201cIt\u2019s up to both sides to make the most of the limited time they have,\u201d he says. \u201cThe patient needs to think about why they\u2019re there, what concerns they have, and what they want to talk about prior to the appointment.\u201d<\/p>\n

Letting patients know not to be afraid to voice concerns is also key. \u201cPart of the job is to engender trust,\u201d Krumholz says. Physicians might want to think of it as a kind of intervention\u2014stepping in and letting patients know they have a safe space to discuss their concerns without fear of being labeled or cut off due to time. For patients with more complex conditions, booking more of the latter can be a huge benefit. \u201cTo have a long appointment to check up on someone with hypertension might be unnecessary. But someone grappling with a complex condition is going to need more time.\u201d<\/p>\n

Part of Frosch\u2019s work is keeping an eye on the future of communications.<\/strong> In addition to more training at the student level, the next generation of exam rooms might help provide a more welcoming environment for two-way conversations.<\/p>\n

\u201cPutting a tablet in the center of a room between the doctor and the patient provides a straight view of the patient,\u201d he says, eliminating the notorious turned-back phenomenon. Technology like Google Glass might also help keep a physician focused on the patient while assisting data is retrieved.<\/p>\n

Most importantly, having a \u201csecond\u201d in the room to transcribe can make a substantial difference. \u201cThat person can do the work of documentation while the physician is doing the work of being a physician,\u201d Frosch says.<\/p>\n

The byzantine world of health care financing might curb some of these ambitions. But it costs nothing for a physician to empower a patient with a voice. \u201cCreating an open environment,\u201d Frosch says, \u201cis letting them know it\u2019s safe.\u201d<\/p>\n

\"\"<\/p>\n","protected":false},"excerpt":{"rendered":"

When psychologist Dominick Frosch first moved to Palo Alto several years ago, one of his first priorities was to establish himself with a new primary care physician. Frosch has Type 1 diabetes, and having a rapport with a doctor to help manage his chronic condition was crucial. But when Frosch walked out of the exam […]<\/p>\n","protected":false},"author":2,"featured_media":17164,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":""},"categories":[113],"tags":[59,62],"class_list":["post-17062","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-patient-experience","tag-patient-retention","tag-patient-trends"],"acf":[],"yoast_head":"\nSolving the Patient-Physician Communications Dilemma<\/title>\n<meta name=\"description\" content=\"Lack of time and digital discomfort is changing the exam room dialogue. 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