INTRODUCTION TO PHYSICIAN-PATIENT COMMUNICATION Ildikó Bán MD Depts. of Family Medicine and General Internal Medicine, University of Pécs 2007

WELLCOME!

WHY IS COMMUNICATION SKILL TRAINING IMPORTANT FOR A FIRST YEAR MEDICAL STUDENT? What we want and don’t want

THE IMPORTANCE OF THE COMMUNICATION SKILLS in foreign countries….. role plays joint consulting video taped consultations case reports

WHAT SHALL WE DO IN THIS SEMESTER? 6 lectures on doctor patient communication, video taped situations 4 small group seminars, role playing interactive teaching methods about the grading feedback

STUDY What makes a doctor good doctor? from the aspect of the patients

STUDY 72% the most important the personal doc-pat. realitionship (pays attention, listents to the patient, shows empathy) 28% the most important the skill and the knowledge (competence, efficiency, time saving)

GOALS Patient’s side: solving the problem understanding the nature of his problem understanding his role in the process

GOALS Doctor’s side: getting the information is there anything else? understanding the problem actual physical and psychological status planning convincing the patient (explanation..) Collaboration with the patient

INTRODUCTION TO PHYSICIAN-PATIENT COMMUNICATION Ildikó Bán MD Depts. of Family Medicine and General Internal Medicine, University of Pécs 2007

SPECIAL FEATURES previous experiences lots of personal and anamnestic details relatives, circumstances, envirnoment different places (office, patient’s home)

STEPS OF THE DOCTOR PATIENT INTERACTION GREETING INTRODUCTION INTERVIEW PHYSICAL EXAMINATION DISCUSSION, DECISION SAYING GOOD BYE

DOCTOR PATIENT ENCOUNTER GREETING: depends:- age, sex - personality mistakes:- intimate, intrusive - self confident - to miss it SAYING GOOD BYE INTRODUCTION INTERVIEW PHYSICAL EXMINATION DISCUSSION DECISION GREETING

DOCTOR PATIENT ENCOUNTER INTRODUCTION: Depends: First meet? mistakes: You miss it The patient starts SAYING GOOD BYE INTRODUCTION INTERVIEW PHYSICAL EXAMINATION DISCUSSION DECISSION GREETING Don’t be afraid to say you are a medical student!

DOCTOR PATIENT ENCOUNTER INTERVIEW: The patient’s goal-let the P. talk Problem oriented proper questions Focus on the most important-ask back mistake: „too much information” „disease oriented” SAYING GOOD BYE INTRODUCTION INTERVIEW PHYSICAL EXAMINATION DECISION DISCUSSION GREETING

DOCTOR PATIENT ENCOUNTER PHYSICAL EXAMINATION: Very intimate Cause as little discomfort as possible! Keep on talking! SAYING GOOD BYE INTRODUCTION INTERVIEW PHYSICAL EXAMINATION DISCUSSION DECISION GREETING

DOCTOR PATIENT ENCOUNTER DISCUSSION, DECISION: Suspected diagnosis plan, steps, prognosis BE UNDERSTANDABLE! mistakes: Not understandable Not controlled The doctor makes the decision THE TRUST IS FUNDAMENTAL The next appointment SAYING GOOD BYE INTRODUCTION INTERVIEW PHYSICAL EXAMINATION DISCUSSION DECISION DISCUSSION DECISION GREETING

DOCTOR PATIENT ENCOUNTER SAYING GOOD BYE: NEVER LET THE PATIENT GO WITH UNANSWERED QUESTIONS Never forget to say good bye Show that you care about your patient SAYING GOOD BYE INTRODUCTION INTERVIEW PHYSICAL EXAMINATION DISCUSSION DECISISON GREETING

DIFFICULT SITUATIONS Angry patient Insecure patient Nervous patient Suicidal Dying patient

POWER OF COMMUNICATION „Doctors who communicate poorly may never be forgiven, those who do it well never will be forgotten.”

SEE YOU SOON!