Physician-patient relationship: Difference between revisions
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After the patient finishing stating their chief concern, responding with "Is there ''something'' else you want to address in the visit today?" rather than "Is there ''anything'' else you want to address in the visit today?" may decrease patients' unmet concerns.<ref name="pmid17674111">{{cite journal |author=Heritage J, Robinson JD, Elliott MN, Beckett M, Wilkes M |title=Reducing patients' unmet concerns in primary care: the difference one word can make |journal=Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine |volume=22 |issue=10 |pages=1429–33 |year=2007 |pmid=17674111 |doi=10.1007/s11606-007-0279-0}}</ref> | After the patient finishing stating their chief concern, responding with "Is there ''something'' else you want to address in the visit today?" rather than "Is there ''anything'' else you want to address in the visit today?" may decrease patients' unmet concerns.<ref name="pmid17674111">{{cite journal |author=Heritage J, Robinson JD, Elliott MN, Beckett M, Wilkes M |title=Reducing patients' unmet concerns in primary care: the difference one word can make |journal=Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine |volume=22 |issue=10 |pages=1429–33 |year=2007 |pmid=17674111 |doi=10.1007/s11606-007-0279-0}}</ref> | ||
===Engaging the patient=== | |||
Encouraging the patient to participate in decisions may increase engagement.<ref name="pmid17986698">{{cite journal |author=Bodenheimer T |title=A 63-year-old man with multiple cardiovascular risk factors and poor adherence to treatment plans |journal=JAMA |volume=298 |issue=17 |pages=2048–55 |year=2007 |pmid=17986698 |doi=10.1001/jama.298.17.2048}}</ref> Using stories to describe medical evidence may help communication.<ref name="pmid17763914">{{cite journal |author=Steiner JF |title=Using stories to disseminate research: the attributes of representative stories |journal=Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine |volume=22 |issue=11 |pages=1603–7 |year=2007 |pmid=17763914 |doi=10.1007/s11606-007-0335-9}}</ref> It is unclear how to overcome difficulties in communicating quantitative information.<ref name="pmid17712082">{{cite journal |author=Ancker JS, Kaufman D |title=Rethinking Health Numeracy: A Multidisciplinary Literature Review |journal= |volume= |issue= |pages= |year=2007 |pmid=17712082 |doi=10.1197/jamia.M2464}}</ref> | |||
===The length of the visit=== | ===The length of the visit=== | ||
Revision as of 14:32, 8 November 2007
The physician-patient relationship is defined as the "interactions between physician and patient".[1]
The medical interview
Being an empathetic listener is helpful.[2]
Greeting the patient
One study of videotaped physician-patient encounters concluded that "physicians should be encouraged to shake hands with patients but remain sensitive to nonverbal cues that might indicate whether patients are open to this behavior. Given the diversity of opinion regarding the use of names, coupled with national patient safety recommendations concerning patient identification, we suggest that physicians initially use patients' first and last names and introduce themselves using their own first and last names."[3]
Hearing the patient's story
Although physicians frequently (3/4s of interviews) interrupt patients before the patient finishes listing their concerns.[4][5] It is not clear that this interruption is bad.[6][7] Not asking for the patient's concerns at all may lead to more concerns arising late in the interview.[4]
After the patient finishing stating their chief concern, responding with "Is there something else you want to address in the visit today?" rather than "Is there anything else you want to address in the visit today?" may decrease patients' unmet concerns.[8]
Engaging the patient
Encouraging the patient to participate in decisions may increase engagement.[9] Using stories to describe medical evidence may help communication.[10] It is unclear how to overcome difficulties in communicating quantitative information.[11]
The length of the visit
Longer visits are associated with higher quality medical care.[12] Patient visits should probably be at least 20 minutes.[9]
References
- ↑ National Library of Medicine. Physician-Patient Relations. Retrieved on 2007-10-22.
- ↑ Epstein RM, Hadee T, Carroll J, Meldrum SC, Lardner J, Shields CG (2007). ""Could this Be Something Serious?" : Reassurance, Uncertainty, and Empathy in Response to Patients' Expressions of Worry". DOI:10.1007/s11606-007-0416-9. PMID 17972141. Research Blogging.
- ↑ Makoul G, Zick A, Green M (2007). "An evidence-based perspective on greetings in medical encounters". Arch. Intern. Med. 167 (11): 1172–6. DOI:10.1001/archinte.167.11.1172. PMID 17563026. Research Blogging.
- ↑ 4.0 4.1 Marvel MK, Epstein RM, Flowers K, Beckman HB (1999). "Soliciting the patient's agenda: have we improved?". JAMA 281 (3): 283–7. PMID 9918487. [e]
- ↑ Beckman HB, Frankel RM (1984). "The effect of physician behavior on the collection of data". Ann. Intern. Med. 101 (5): 692–6. PMID 6486600. [e]
- ↑ Dyche L, Swiderski D (2005). "The effect of physician solicitation approaches on ability to identify patient concerns". Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine 20 (3): 267–70. DOI:10.1111/j.1525-1497.2005.40266.x. PMID 15836531. Research Blogging.
- ↑ Thomas Mordekhai Laurence (2004). Extreme Clinic -- An Outpatient Doctor's Guide to the Perfect 7 Minute Visit. Philadelphia: Hanley & Belfus. ISBN 1-56053-603-9.
- ↑ Heritage J, Robinson JD, Elliott MN, Beckett M, Wilkes M (2007). "Reducing patients' unmet concerns in primary care: the difference one word can make". Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine 22 (10): 1429–33. DOI:10.1007/s11606-007-0279-0. PMID 17674111. Research Blogging.
- ↑ 9.0 9.1 Bodenheimer T (2007). "A 63-year-old man with multiple cardiovascular risk factors and poor adherence to treatment plans". JAMA 298 (17): 2048–55. DOI:10.1001/jama.298.17.2048. PMID 17986698. Research Blogging.
- ↑ Steiner JF (2007). "Using stories to disseminate research: the attributes of representative stories". Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine 22 (11): 1603–7. DOI:10.1007/s11606-007-0335-9. PMID 17763914. Research Blogging.
- ↑ Ancker JS, Kaufman D (2007). "Rethinking Health Numeracy: A Multidisciplinary Literature Review". DOI:10.1197/jamia.M2464. PMID 17712082. Research Blogging.
- ↑ Wilson A, Childs S (2002). "The relationship between consultation length, process and outcomes in general practice: a systematic review". The British journal of general practice : the journal of the Royal College of General Practitioners 52 (485): 1012–20. PMID 12528590. [e]