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Patient Talk 101: Tips for Effective and Efficient Patient Communication. Jeannie A. Sperry, PhD Associate Professor Director of Behavioral Science Education Department of Family Medicine Teaching Scholars Alumnus West Virginia University Thursday, November 20, 2008. Learning Objectives.
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Jeannie A. Sperry, PhDAssociate ProfessorDirector of Behavioral Science EducationDepartment of Family MedicineTeaching Scholars AlumnusWest Virginia University
Thursday, November 20, 2008
1. Attend to the setting
2. Identify the person with the problem
3. Clarify the patient’s agenda
How much time do you think passes before the average health care interview is shifted from exploring the patient’s agenda and concerns to the interviewer asking specific focused questions?
A. 20 seconds
B. 60 seconds
C. 90 seconds
909 pts at 45 FM, IM, Cardiology practices
11.6% reported > 1 unmet expectation
2 weeks later, visits with unmet expectations:
“What brings you in today?”
Main reason for today’s visit___________________
If time, other concerns I would like to discuss:
__I need refills __I need referral
__I need school or work excuse
__I need the attached forms filled out
__I would like to discuss stopping smoking
Filled out by __patient or __nurse.
Heritage et al, 2007
Starfield et al, 1981, at John Hopkins
Bass et all, 1986, University of Western Ontario
Of course you may not know what the cause is, yet many people have some idea or concern about what their symptoms may represent. It would help me if you could share any of these ideas.
That must be frustrating for you.
I can see why you’d be so concerned.
“Chatty doctors forget patients” in NY Times
100 PCP. Audio recordings of pt visits. 4/5 times when doctor interjected personal information, never returned to topic.Empathy: Focus on Patient’s feelings
Clinical Empathy is a Clinical Procedure
(Not all pts want antibiotic or opioid)
6. Transition: As we wrap up today, let’s make sure we are on the same page….
7. Can you help me remember what we’ve agreed to do?
Ask patient to restate the plan.
8. What might get in the way of this plan?
9. Stand up. Prepare to exit…
10. If “oh by the way, doc…” Too important. RTC to discuss.
Background: What is going on in your life? Tell me more…
Affect: What’s that like for you?How do you feel about what is going on?"
Trouble: What about the situation troubles you the most?
Handling: How are you handling that?
Empathy: That must be very difficult for you.
Source: Stuart, M.R. and Lieberman, J.A. III. (2002). "The Fifteen Minute Hour: Practical Therapeutic Interventions in Primary Care" 3rd Edition. Philadelphia: Saunders.
BATHEd patients reported higher satisfaction for 8 of 11 factors
Recommending to others
Today’s visitBATHEd Patients: Higher Satisfaction
Platt & Gordon (2004) Field Guide to the Difficult Patient Interview. NY: Lippincott, Williams, & Wilkins.