The Dermatologist-Patient Relationship

1. The Dermatologist-Patient Relationship Matthew H. Kanzler, MD Clinical Professor Assoc. Residency Program Director Stanford University Dept of Dermatology Chief of Dermatology Santa Clara Valley Medical Center

2. Conflict of Interest Statement • I have no conflicts of interest to report • I receive no money from any company or industry for anything • I am on no speaker bureaus • I am not a paid consultant

3. Importance of Office Staff • The appointment starts with the first phone call, and ends with the checkout process • MD-patient interaction is small portion of overall appointment experience • Hire personalities, not résumés • Utilize Medical Assistants!

4. Efficient Office Flow • Realistic scheduling templates • Keep patients informed of delays longer than 15 minutes • Acknowledge delays, apologize sincerely, and proceed with visit

5. Components of an Efficient Dermatologist-Patient Relationship • Rapport Building • Collaborative Agenda Setting • Elicit Patient’s Perspective • Co-Create a Plan • Patient Education

6. Rapport Building • Professional appearance • White coat • Name badge • Leave “dress-down” Fridays to Yahoo! • Warm greeting, handshake • Brief non-medical interaction • Constant eye contact

7. Collaborative Agenda Setting • Determine number & importance of all of patient’s problems up-front • Confirm MA’s intake with patient • “Anything else?” • Prioritize • Confirm with patient expectations of current visit

8. Elicit Patient’s Perspective • Patient’s beliefs and fears • Knowledge of disease, treatment • “cancer, contagious, AIDS” • Family or cultural influences • Watch for nonverbal clues • Patient’s ideas for next steps

9. Co-Creating a Plan • Patients are more satisfied and have better outcomes when they are involved in treatment plan creation • Adherence to Tx plan dependent on: • Financial resources • Social resources

10. Co-Creating a Plan • Agree on goals of care, next steps, role of patient & family members • Keep plans simple at first • Allow time for plan adjustment in response to patient preferences and limitations

11. Patient Education • Patients will remember half of what you tell them • Utilize MAs to provide education • Provide written handouts to complement instructions • Emphasize preventative measures/ behavioral changes