Communication with Patients, Families, and Coworkers Chapter 4 Communication with Patients, Families, and Coworkers PowerPoint® presentation to accompany: Medical Assisting Third Edition Booth, Whicker, Wyman, Pugh, Thompson

Learning Outcomes 4.1 Identify elements of the communication circle. 4.2 Understand and define the developmental stages of the life cycle. 4.3 Give examples of positive and negative communication.

Learning Outcomes (cont.) 4.4 List ways to improve listening and interpersonal skills. 4.5 Explain the difference between assertiveness and aggressiveness. 4.6 Give examples of effective communication strategies with patients in special circumstances.

Learning Outcomes (cont.) 4.7 Discuss ways to establish positive communication with coworkers and management. 4.8 Describe how the office policy and procedures manual are used as a communication tool in the medical office.

Learning Outcomes (cont.) 4.9 Describe community resources and how they enhance the services provided by your office. 4.10 Explain how stress relates to communication and identify strategies to reduce stress.

Introduction Medical assistants must Recognize human behaviors Communicate effectively, with professionalism and diplomacy Recognize obstacles that affect therapeutic communication

Communicating with Patients and Families You are the key communicator between the physician and patient Your interaction sets the tone for the office visit Developing strong communication skills is just as important as mastering administrative and clinical skills Communication will influence how comfortable the patient feels in your practice.

Communicating with Patients and Families (cont.) Customer service Most important part of communication Two points fundamental to customer service The patient comes first Patient needs are satisfied Patients are #1!

Communicating with Patients and Families (cont.) Examples of customer service Telephone techniques Writing or responding to telephone messages Explaining procedures to patients Assisting with billing issues Creating a warm and reassuring environment

Apply Your Knowledge Good! What are the two key parts of customer service? ANSWER: The two fundamental parts of customer service are that the patient comes first and you must satisfy patient needs. Good!

The Communication Circle The communication cycle involves an exchange of messages through verbal and nonverbal means.

Communication Process Patients often believe that health care has become impersonal due to Technological advances Managed care organizations Maintain a patient-centered approach

Apply Your Knowledge What are the three elements of the communication circle? ANSWER: The three elements of the communication circle are the message, source, and receiver. RIGHT!

Human Behavior: Stages of the Life Cycle Understanding growth and development enhances communication skills Physical development Psychological growth Guidelines for communication based on developmental stage Infant Toddler Preschooler School age Adolescence Young, middle, old adult

Maslow’s Hierarchy of Human Needs Self-Actualization Esteem Needs Love Needs Safety Needs Physiological Needs Deficiency Needs

Apply Your Knowledge Good Answer! You can communicate with all people in the same way. Is this statement true or false, and why? ANSWER: The statement is false. Not all people are at the same place on Maslow’s hierarchy of human needs. To communicate effectively with a person, you need to understand what he or she is deficient in. For example, you would use different communication styles when talking to a homeless person who may have psychological and safety needs than when talking to an elderly person who is lonely and depressed due to the recent loss his or her spouse. Good Answer!

Types of Communication Positive or negative Verbal or non-verbal Written (Chapter 7)

Positive Communication Communication promotes the patient’s comfort and well-being Set the stage for positive communication Encourage patients to ask questions Speak slowly and clearly

Negative Communication Curb negative communication habits Mumbling Speaking brusquely Avoiding eye contact Interrupting patients as they speak Rushing explanations Forgetting common courtesies Showing boredom Treating the patient impersonally

Body Language Facial expression Eye contact Posture Open Closed Touch Personal space In many instances, people’s body language conveys their true feelings, even when their words may say otherwise.

Apply Your Knowledge YEA! Mr. Garcia comes to the desk to check in and asks if he will be seen on time. The receptionist continues with her paperwork, points to the sign-in sheet, and tells Mr. Garcia: “Just sign in. The doctor will be with you when he can.” Explain why this is an example of negative communication. ANSWER: This is an example of negative communication because the clerk Did not stop what he or she was doing – was not friendly or attentive Did not greet Mr. Garcia or make eye contact with him Did not give a satisfactory answer to Mr. Garcia’s question Did not make sure Mr. Garcia understood when he would be seen

Improving Communication Skills Listening skills Passive listening Active listening Improve listening skills Prepare to listen Relax and listen attentively Maintain eye contact Maintain personal space Think before you respond Provide feedback

Improving Communication Skills (cont.) Interpersonal skills Warmth and friendliness Empathy Respect Genuineness Openness Consideration and sensitivity

Therapeutic Communication The ability to communicate with patients In terms they can understand So they feel at ease and comfortable The ability to communicate with other members of the health-care team Technical terms Appropriate to the health-care setting

Therapeutic Communication (cont.) Involves Silence Accepting Giving recognition Offering self Giving a broad opening Offering general leads Making observations Encouraging communication Mirroring Reflecting Focusing Exploring Clarifying Summarizing

Ineffective Therapeutic Communication Roadblocks Reassuring Giving approval Disapproving Agreeing/ disagreeing Advising Probing Defending Requesting an explanation Minimizing feelings Making stereotyped comments

Defense Mechanisms Unconscious, designed to protect self Patients may display Compensation Denial Displacement Dissociation Identification Introjection Projection

Assertiveness Skills Assertive – people who are firm and stand by principles while still showing respect for others Requires Openness Honesty Directness Aggressive – people who try to impose their position on others or try to manipulate them

Apply Your Knowledge Good Answer! What is the difference between being aggressive and being assertive? ANSWER: Assertiveness means standing by your principles while showing respect for others. You trust your instincts, feelings, and opinions and act on them. An aggressive person tries to impose his or her own position on others or tries to manipulate them. He or she is bossy, may be quarrelsome, and does not consider others’ feelings, needs, thoughts, ideas, or opinions. Good Answer!

Communication in Special Circumstances Anxious patient Can interfere in communication process May not listen well or pay attention to what you are saying Observe for Tense appearance Increased blood pressure and breathing Sweaty palms Irritability and agitation

Angry Patient Goal is to help the patient express anger constructively Steps in communicating with an angry patient Recognize anger and its cause Remain calm and demonstrate respect Focus on physical and medical needs Maintain adequate personal space Do not take anger personally Ask patient to be specific concerning cause Present your point of view Avoid breakdown of communication Leave if you feel physically threatened

Patients from Other Cultures Each patient has his or her own behaviors, traditions and values Strive to understand and be tolerant Stereotyping Negative statement about specific traits of a group applied to an entire population Generalization Statement about common trends within a group

Patients from Other Cultures (cont.) Attitudes about health care Beliefs about causes of illness Symptoms and what they mean Treatment expectations Language barriers

Patients with Visual Impairment Use large-print materials Use adequate lighting in all areas Use a normal speaking voice Talk directly and honestly Do not talk down to the patient Preserve the patient’s dignity

Patients with Hearing Impairment Find a quiet area to talk Minimize background noise Position yourself close to and facing the patient Speak slowly Remember that elderly patients lose the ability to hear high- pitched sounds first Verify understanding Use written material Speak clearly but do not shout

Mentally or Emotionally Disturbed Determine what level of communication the patient can understand Suggestions Remain calm if the patient becomes agitated or confused Avoid raising your voice Avoid appearing impatient

The Elderly Patient Be respectful Do not talk down to elderly person Tips for communication Act as if you expect the patient to understand Respond calmly to any confusion Tell the truth and use simple questions and terms Ask the patient to relax, speak slowly, and ask the patient to repeat if you do not understand

Terminally Ill Patients Often under extreme stress, so offer support and empathy Kubler-Ross’s Stages of Dying Denial Anger Bargaining Depression Acceptance

Young Patients and Their Parents Recognize and accept their fear and anxiety Explain all procedures Use praise Do not tell children that a procedure will not hurt if it will, or you will lose their trust Reassuring and keeping parents calm will also help the child relax

Patients with AIDS/HIV Stigma of disease Guilt Anger Depression You must have accurate information about the disease and the risks involved to answer the patient’s questions Patients need human contact and to be treated with dignity

Patient’s Family and Friends Provide emotional support to the patient Acknowledge family members and friends Keep them informed about patient’s progress Remember to protect patient confidentiality Ask the patient what information can be given to family or friends.

Apply Your Knowledge Right! What can you do to promote communication with someone who is visually impaired? ANSWER: Use large-print materials, adequate lighting in all areas, and a normal speaking voice. Talk directly and honestly, but do not talk down to the patient; preserve the patient’s dignity. Right!

Communication with Coworkers Develop rapport with coworkers Rules for the medical office Use proper channels Have a proper attitude Plan an appropriate time for communication

Communicating with Management Keep supervisor informed Ask questions Minimize interruptions Show initiative

Dealing with Conflict Do not “feed into” others’ negative attitudes Be personable and supportive Refrain from passing judgments Do not gossip Do not jump to conclusions

Apply Your Knowledge Bravo! What strategies can you use to avoid conflict in the workplace? ANSWER: You can use the following strategies to avoid conflict in the workplace: Do not “feed into” others’ negative attitudes Be personable and supportive Refrain from passing judgments Do not gossip Do not jump to conclusions Bravo!

Policy and Procedures Manual Key written communication tool Policies Dictate the day-to-day workings of an office Describe chain of command Procedures Detailed instructions for specific procedures

Policies Salary evaluations Office purposes Maintenance of equipment Mailings Bookkeeping Scheduling appointments OSHA Office purposes Rules and regulations Job descriptions Office hours Dress code Insurance Vacation and sick leave

Procedures Purpose of test, clinical application, and usefulness Specimen required and collection method Special patient preparations or restrictions Reagents, standards, controls, and media used Instrumentation Calibration and schedules Step-by-step directions

Community Resources Resources Alcoholics Anonymous Shelters Hospice Mental health services Meals on Wheels PASSPORT Easter Seals State agencies Support groups Good customer service is founded on providing or researching services to assist in attaining the goal of patient health and well-being Discuss with patient’s physician before referring patient

Other Resources Reference laboratories Insurance companies Office equipment suppliers Maintenance companies

Apply Your Knowledge Right! What is the difference between policies and procedures? ANSWER: Policies dictate the day-to-day workings of an office and usually describe the chain of command. Procedures are the detailed instructions for specific procedures. Right!

Managing Stress Stress can be a barrier to communication Stress can occur Due to a feeling of being under pressure As a reaction to anger, frustration, or change in routine Stress is normal Motivating More productive

Managing Stress (cont.) Ongoing stress Overwhelming Physical effects Reducing stress Consider your strengths and limitations Be realistic about commitments both at work and in your private life Techniques to reduce stress

Apply Your Knowledge Right! List three things you can do to relieve stress. ANSWER: Any of the following can help you reduce stress: Exercise regularly Eat a balanced diet Get enough sleep Set realistic goals Be organized Change what you have control over Keep focused Identify sources of conflict Maintain a sense of humor Try not to overreact Right!

Burnout Burnout is the end result of prolonged periods of stress without relief Type A personality Highly driven, perfectionist-type person More susceptible to burnout Type B personality More relaxed, calm, “laid back” Less prone to burnout

Burnout (cont.) Stages to burnout Phoenix phenomenon Honeymoon Awakening Brownout Full-scale burnout Phoenix phenomenon

Preventing Burnout Take time to rest and relax Be realistic about job expectations, your aspirations, and your goals Create a balance in life

Apply Your Knowledge Good Job! What are the phases of burnout? ANSWER: The phases of burnout are Honeymoon Awakening Brownout Full-scale burnout Good Job!

Medical Assistant In Summary You are the key link between the office and patient Communication Skills: Listening, interpersonal, and assertiveness People with Special Needs: Anxious, angry, elderly, hearing and visually impaired Develop working relationships and help office run smoothly.

End of Chapter 4 Often during life-altering experiences, patients and their loved ones need a shoulder to cry on or someone to comfort them. It is important for them to know support is there. —Lindsey D. Fisher (The Healers Art)