Patient satisfaction from physicians' communication - Essay Example

Patient satisfaction from physicians' communication Ineffective communication has been reported as one of the main contributing factors in medical errors today in the UK with hundreds of patients suffering from injury occasioned by the medical officers due to miscommunication. In addition to physical and psychological harm, ineffective communication also portends financial consequences since errors are often followed by expenses in further treatment, lawsuits or dispensing remedial drugs or treatment regimens that all go to waste. Given the ever-increasing complexity and diversity of health care today, improving the state of communication is a crucial since in the face of the diversity, especially due to new technology and knowledge since the list of things that can go long grows every day. The institute of medicine in its report in health recently discovered that many of the employees in the health care sector lack sufficient training in communication, which limits their effectiveness (Institute of Medicine 2003). They underscored the importance of patient centred care which can only be achieved if there is adequate flow of information between the practitioners and patients. To this end they emphasis on the patient care model which places great emphasis on open enquiry, reflective listening and empathy as one of the most effective and important ways of responding to the diverse patient needs. In the HCPC Standards of Proficiency  (2013 p.8) Standard 8, ‘Be able to communicate effectively’, 8.3 states that a  physiotherapist must:  “Understand how communication skills affect assessment and engagement of service users and how the means of communication  should be modified to address and take account of factors such as age,  capacity, learning ability and physical ability.” As a result, this paper attempts to establish why effective communication between the patient and doctor is crucial by examining different case scenarios and evaluating the role communication plays, not only just in the physiotherapist context, but also in the healthcare system in general. Verbal communication between doctors and their clients is recognized as a core part of care and in conventional scenarios it is easy to decode and analyses, and this is because it is discrete in nature and has clear endpoints. However, for doctors to be effective at it, they must have good interpersonal skills such that they can make the patient feel at ease and encourage them to open up with alarming them, sounding rude or stereotypical. In their discourse, they should ensure they show empathy and attention to the patient’s situation and be capable of managing the patient’s expectations without discouraging them (Larsen and Smith 1981). A doctor should at least be competent in the language through which he communicates with patients, the HCPC (2013) manual stipulates that the must be effective to at least level 7 of English Language Testing System, (ELTS). This is critical since a miscommunication between the doctor and patient can have fatal results since they are primary source of information the doctor uses to diagnose treat. Nonetheless, verbal and language skills alone are not sufficient in and doctor should integrate nonverbal communication in their discourse by both controlling the cues they send out and reading the client’s (Hall, Harrigan & Rosenthal 1995, p.24). Unlike verbal communication, non-verbal cues are involuntary and they can on be very enlightening to the doctor when employed resourcefully. They occupy the background of every doctor patient interview and takes place even in silence although this makes it comparatively more difficult to interpret (Dimatteo et al 1980, p.380). Doctors should learn to use this to create trusting relationships with their patients; in addition, nonverbal cues from the patient can tell a lot that they either cannot or will not say (Byrne & Heath 1980, p.230). In a study carried out in Poland, it emerged that the doctor’s tone and facial expressions as well as other gestures were used to determine if they are genuinely interested in the patients’ welfare (Silverman and Kinnersley, 2010, p.76). Therefore, if they gauge the doctor to be attentive, they were likely to be more forthcoming than if they imagined he was just going through the motions. None verbal cues include among others facial expression, gestures, posture, eye contact smiling and frowning, the doctor should learn to presents himself in as controlled a manner as possible so he can control the message he passes to the clients. For example, no matter how reassuring one is in their words, if they discuss a diagnosis with a deep frown; for instance, the patient may believe they are being told what they want to hear. The Archives of instant medicine carried out a study, to investigate the quality of patient doctor communication and establish its effectiveness by gauging the beliefs held by both parties involved. The results were both uprisings and worrying: the study was based on a conducted on 89 patients and 43 physicians who attended to them at some point between October 2008 and June 2009 at the Waterbury Hospital, a private, non-profit hospital in Connecticut affiliated with Yale University School of Medicine (Adams 2012, p.1184). The research revealed numerous discrepancies in the basic information that transpired between doctors and patients ranging from minor to serious ones (Yin, 2010). For one, 66 percent of the doctors believed their patients knew them by name; however, only 18 percent of the patients could correctly say their doctor’s names. Another information gap was revealed in the fact that only 57 percent of the patient reported to know what the doctor had diagnosed them (Adams 2009, p.1187). Surprisingly, 77 percent of the doctors were convinced their patients knew the diagnosis. This particular comparison evinced the glaring gaps in the communication process given that doctors and patients seem to be reading from a radically different script despite the fact that the harmony in their communication is one of the biggest determinants of the treatment outcome. Drug side effects are responsible for a variety of negative outcomes in the treatment process; patients who react negatively to some treatments often end up discontinuing the drugs either because they cannot tell apart the side effects from the illness itself (Bezreh, 2011, 11). This is often because they do not have sufficient information on what to expect although the attending physician should provide data in clear and unambiguous terms. In more serious cases, the patient may be adversely affected by certain drugs owing to pre-existing conditions or other drugs they are taking, in some cases they may even up with worse medical conditions or even die (Varprio et al. 2008, p.71). Finally, the survey found a sharp contrast between the patents and doctors views on discussing the anxieties and fears of the latter, while 98 % of the doctors claimed they had given the patients a forum to discuss these, only 46 percent of the parents felt they had been given an adequate opportunity to express themselves. As aforementioned, age is one of the major considerations that one therapist need to take to account when communicating with their patients, this applies to very young or the elderly patients. In many cases, when dealing with young patients doctors are often required to be very patient and show both empathy and perception so they can understand their clients well enough to help them. Children can at times fail to grasp the importance of disclosing everything to the therapist or they may even fear or simply not know what to say. Therefore, the doctor must possess adequate communication skills to make the child comfortable and create and enabling environment for open discourse. One of the major challenges that impair the effectiveness of communication between young patients and doctors is that the latter treat the former as if they were simply small adults. As a result they take their word for its face value without considering that the child may not be capable of describing the symptoms or providing comprehensive feedback to the doctors queries or treatment methodologies. For best results when dealing with children, doctors are encouraged to apply the four Es that represent engagement, empathy enlistment and education. Communicating with children is made complex by the fact that their perception of their body’s changes with age and thus a physician must be attuned with how a patient perceives himself or herself before they can hope to effectually communicate (Sabroe, Ammentorp & Mainz 2005, p.127). To facilitate effective communication, the child must be made to feel at ease and this is first achieved by ensuring that the environment is as non-threating as possible with child friendly charts and pictures one the wall as well as cheerful colour and toys in the waiting room for younger ones. In addition, the children are very highly tuned to non-verbal cues and if doctor should take cognizance f this to avoid frightening the child through gestures that would not be alarming in an adult scenario. A therapist for example should avoid frowning at X Rays or the child’s medical history since the frown may be misinterpreted by the child leading to panic and ultimate communication breakdown. In addition, whispering has been found to be effective in getting a child’s attention since they will focus on straining to hear whom the doctor is saying and forget their fear. In case of linguistic or other technical difficulties in communication, the doctor should recruit the assistance of an intermediary, perhaps a sibling parent interpreter, furthermore “soft” words and expressions should be used since children ill easily get scared if they attribute harsh expressions to themselves. For example, a doctor may use, “different appearance” instead of “deformity” “picture” instead of “X-ray” or “wonder” in pace of “worry”. Largely, tradition discourse on practitioner-patient information has been focused on adults relegating of paediatric communication to the background, however contemporary discourse predominantly features it, which is a reflection or increased awareness of the importance of adaptive communication skills. Cultural diversity presents doctors with myriad complication in respect to communication, since in such scenarios the challenges to health and functional literacy are often exacerbated. Consequently, there have been numerous reports of barrier to communication among minority groups that sometimes results in reduced participation or inadequate utilization of the health care facilities (Suter et al. 2009, p.42). This situation is further compounded by the fact that educational material often falls short of reaching individuals from cultural minorities. In addition even when it does, in countries like the US or UK, it is reflective of the predominant western culture; for example, in matters dieting, the information circulated will often be restricted to the western dieting experience resulting in the preclusion or staples from different cultures such as Tortillas. In direct communication between health works and clients, this is evinced more directly through the symbolic interactionism point of view, the symbols that doctor take for granted may mean radically different thing to the patients. This often applies in case of colour, and the doctor may code some information in red to show danger but the patient may be from a culture where the same colour is representative of wealth and prosperity. As a result, the two of them may share the message, but the patient fails to get the warning and this may influence their attitude towards the treatment they are receiving. Contrary to popular assumption, language is not the main mediator of intercultural discourse, it is not enough that the doctor understands the language of the patient, they needs must be capable of translating and identifying the information they are getting from a cultural context. In this way, there can be a mutual understanding so that doctors across the cultural board can make similar conclusions from the same data and therefore be more accommodating towards different patient’s different perceptions (Zandbelt, et al. 2007, p.401). The value of good communication is further enhanced by evidence that it improves the adherence, to therapy satisfaction with treatment and at the end of the end when doctors succeed at creating a rapport with patient, they substantially increase their chances of a positive outcome. Poor communication on the other hand is often associated with malpractice suits, (Gordon and Sharp 2010, p.294), which it has been found are often a result of the doctor and patient or doctors and other health care practitioner attending to the client (Leonard, Graham & Bonucom, 2004. p.188). Reference List Bezreh, T. et al. 2011. Challenges to physician–patient communication about medication use: a window into the skeptical patient’s world. 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