Skills in medical communication

1. Skills in medical communication Dr.T.V.Rao MD Dr.T.V.Rao MD

2. I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone. All that come to my knowledge in the exercise of my profession or in the daily commerce with men, which ought I not to be spread abroad, I will keep secret and will never reveal. *Practice of ethics reduces litigations it is true Consultation / communications skills Probably the most important skill in medicine*Hippocratic oath Dr.T.V.Rao MD

3. Communication skills in Medical Practice • Developing strong communication skills is integral to becoming an effective health provider. In recent years good doctor–patient communication has been linked to improved patient satisfaction, better patient care and a decrease in malpractice lawsuits. Dr.T.V.Rao MD

4. What doctors need • Knowledge • Ability to elicit information from patients • Interpersonal skills to respond to patients’ feelings and concerns Dr.T.V.Rao MD

5. Communication Skills • To diagnose and treat disease • To establish and maintain a therapeutic relationship To offer information and educate Dr.T.V.Rao MD

6. Creating skills in Medical communication continues to be a challenge • Recognised its importance, medical schools/colleges have strived to teach students not only the science of medicine, but also the art of communication. Unfortunately, creating methods for teaching communication skills that are effective and enjoyed by most students is challenging. Dr.T.V.Rao MD

7. Respecting patients a great skill • Remember that every patient could be you, your mother, your brother or your sister. How would he or she feel waiting for the doctor to come into the room Dr.T.V.Rao MD

8. Respecting patients makes your job easy • Introduce yourself to the patient. Explain your role. • Shake hands, but don’t force physical contact if • patient is uncomfortable. Call the adult patient Mr., Mrs., or Ms. (do not use first name ) Maintain privacy. • Keep doors and curtains closed. • Acknowledge and greet others in the room. Dr.T.V.Rao MD

9. Your appearance increases confidence Maintain a professional appearance Clean, neat, “conservative,” See dress code in syllabus Goal is to inspire confidence Dr.T.V.Rao MD

10. Make your patients comfortable • Make sure the patients comfortable. • Sit at the patient’s level. Be aware of the patient’s personal space (can vary among cultures.) Continue to consider the patient’s comfort during the history and physical. Dr.T.V.Rao MD

11. To get the most out of the consultation for the patient foremost and for the doctor. To plan the consultation using a framework To adapt your style of consulting to meet the needs of the patient To handle difficult situations To have “rescue” plans when things go wrong To use time efficiently in the consultation To be able to assess and improve the consultation Consultation skills The most important skill in medicine Dr.T.V.Rao MD

12. Communication skills part of your management • In order to deliver effective healthcare, doctors are expected to communicate competently both orally and in writing with a range of professionals, managers, patients, families and carers Dr.T.V.Rao MD

13. Communication is the major part of Medicine • Good communication skills are integral to medical and other healthcare practice. • Communication is important not only to professional-patient interaction but also within the healthcare team. The benefits of effective communication include good working relationships and increased patient satisfaction. Effective communication may increase patient understanding of treatment, improve compliance and, in some cases, lead to improved health Dr.T.V.Rao MD

14. Task Orientated Patient centred Doctor centred Behaviour Orientated Dr.T.V.Rao MD

15. Communication skillsSome techniques • Developed fluent dialogue with patient • Used silence effectively, allowing patient enough time to express thoughts or feelings • Actively encouraged patient through use of supportive words or comments • Dialogue with patient was enhanced by effective use of non-verbal behaviour • Used open, exploratory questions – inviting patient to become actively involved • Adjusted language as appropriate, to suit particular needs of the situation Dr.T.V.Rao MD

16. Knowledge can understand a problem but cannot solve without empathy • Some people think only intellect counts: knowing how to solve problems, knowing how to get by, knowing how to identify an advantage and seize it. But the functions of intellect are insufficient without courage, love, friendship, compassion and empathy. Dr.T.V.Rao MD

17. Most important demand from patientsempathy • Empathy: “The ability to understand and share the feelings of another.” from Greek empatheia (from em- ‘in’ + pathos ‘feeling’) This sums up what empathy is: I am here with you, I give you hope, and accompany in your feeling Dr.T.V.Rao MD

18. Practice little empathy just not sympathy • Is the ability to understand the patient’s experiences and feelings accurately as well as to demonstrate that understanding to the patient. 􀁼 Is an active process. 􀁼 Is more than sympathy, or feeling sorry for someone. Dr.T.V.Rao MD

19. Start practicing empathy • Empathy requires listening. Remain quiet and let the patient talk. • Silence can be helpful, don't be afraid of it. Use open ended questions. Use “continuers” and echoing. Dr.T.V.Rao MD

20. Patientologist • Patientologists. They are empathetic; and understand what the patient's fears and worries are, so that they can help them to manage them. • How does a doctor become a good patientologist ? Unfortunately, these skills are never taught formally in medical college. Some doctors have a great bedside manner, because they have a high EQ ( emotional quotient). Others learn how to improve their patient skills by emulating their teachers who are good clinicians Dr.T.V.Rao MD

21. Do you know many patients complain doctors are not listening just start investigating • Enhance empathy by the way you respond to what the patient says. 􀁼 Show the patient you have been listening to the content of their problem. Show the patient you understand their perspective on the problem Dr.T.V.Rao MD

22. Providing opportunities for better communication • Education providers need to ensure that appropriate and effective training opportunities are available to doctors to develop and refine such skills in order to facilitate interaction with patients and others. Dr.T.V.Rao MD

23. Your first task to get history needs effective communication • In all doctor-patient interactions a variety of communication skills will be required for different phases of the consultation. During the start of a consultation, doctors must establish a rapport and identify the reasons for the consultation. They must go on to gather information, structure the consultation, build on the relationship and provide appropriate information Dr.T.V.Rao MD

24. Students should be trained in dealing with • Students must have opportunities to practise communicating in different ways, including spoken, written and electronic methods. There should also be guidance about how to cope in difficult circumstances. Some examples are listed below: a. breaking bad news • b. dealing with difficult and violent patients • c. communicating with people with mental illness, including cases where patients have special difficulties in sharing how they feel and think with doctors • d. communicating with and treating patients with severe mental or • physical disabilities • e. helping vulnerable patients.

25. Today’s doctors dependent on patient satisfaction ……….. • The doctor-patient relationship is improved. The doctor is better able to seek the relevant information and recognise the problems of the patient by way of interaction and attentive listening. As a result, the patient’s problems may be identified more accurately. • • Good communication helps the patient to recall information and comply with treatment instructions thereby improving patient satisfaction. • • Good communication may improve patient health and outcomes. Better communication and dialogue by means of reiteration and repetition between doctor and patient has a beneficial effect in terms of promoting better emotional health, resolution of symptoms and pain control. Dr.T.V.Rao MD

26. Clinical errors are costly communication reduces • The overall quality of care may be improved by ensuring that patients’ views and wishes are taken into account as a mutual process in decision making. • Good communication is likely to reduce the incidence of clinical errors. Dr.T.V.Rao MD

27. Effective communication benefits doctors and reduces litigations • Effective communication skills may relieve doctors of some of the pressures of dealing with the difficult situations encountered in this emotionally demanding profession. Problematic communication with patients is thought to contribute to emotional burn-out and low personal accomplishment in doctors as well as high psychological morbidity. Being able to communicate competently may also enhance job satisfaction. • Patients are less likely to complain if doctors communicate well. There is, therefore, a reduced likelihood of doctors being sued Dr.T.V.Rao MD

28. All medical and paramedical staff are in communicating the facts to patients • Good communication within the healthcare team is essential in order to ensure continuity of care and effective treatment for patients. Moreover, poor communication between professional staff has been identified as an underlying factor for failed communication with patients. For example, a patient may be given different information regarding their condition by different members of the healthcare team. Dr.T.V.Rao MD

29. To be a better practitioner practice good communication • To diagnosis and treat disease and maintain a therapeutic relationship: Data from the patient must be objective, precise and reliable. You must demonstrate respect, genuineness and empathy. These skills can be learned with practice! Dr.T.V.Rao MD

30. Communication skills to be included in student appraisal • Communication skills are now regarded as a core competence. Assessment of communication skills will be necessary as part of the doctors appraisal and personal development plans. In addition, revalidation will also take communication skills into account Dr.T.V.Rao MD

31. What our medical students need • Medical schools / Colleges must be encouraged to provide the best possible communication skills training as part of the core undergraduate curriculum. This training should have set objectives and clear methods of assessment. • More communication skills training programmes should be developed at postgraduate level. Doctors could use the appraisal process as a vehicle for discussing the success of communication skills training Dr.T.V.Rao MD

32. The Institute of Medicine’s 2000 report • To Err is Human: Building a Safer Health System” suggested that close to 90% of medical errors are a result of failed systems and procedures. The Joint Commission, which accredits and certifies more than 15,000 health care organizations and programs in the United States, cites team training as an essential factor in reducing risk of medical errors. • Communication skills too are very Important • Professional coordination is basis of success Dr.T.V.Rao MD

33. Programme Created by Dr.T.V.Rao MD for Medical and Health Care Workers in the Developing World • Email • doctortvrao@gmail.com Dr.T.V.Rao MD