introduction to physician-patient communication ildikó bán md depts. of family medicine and...

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 FEATURESSPECIAL FEATURES

previous experienceslots of personal and anamnestic detailsrelatives, circumstances, envirnomentdifferent places (office, patient’s home)

STEPS OF THE DOCTOR PATIENT INTERACTION

GREETING INTRODUCTION INTERVIEW PHYSICAL EXAMINATION DISCUSSION, DECISION SAYING GOOD BYE

DOCTOR PATIENT ENCOUNTERDOCTOR PATIENT ENCOUNTER

GREETING:

depends:- age, sex- personality

mistakes: - intimate, intrusive- self confident- to miss it

SAYING GOOD BYE

INTRODUCTION

INTERVIEW

PHYSICAL EXMINATION

DISCUSSIONDECISION

GREETINGGREETING

DOCTOR PATIENT ENCOUNTERDOCTOR PATIENT ENCOUNTER

INTRODUCTION:

Depends: First meet?

mistakes: You miss it The patient starts

SAYING GOOD BYE

INTRODUCTIONINTRODUCTION

INTERVIEW

PHYSICAL EXAMINATION

DISCUSSIONDECISSION

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

INTERVIEWINTERVIEW

PHYSICAL EXAMINATION

DECISIONDISCUSSION

GREETING

DOCTOR PATIENT ENCOUNTERDOCTOR PATIENT ENCOUNTER

PHYSICAL EXAMINATION:

Very intimate Cause as little discomfort as

possible! Keep on talking!

SAYING GOOD BYE

INTRODUCTION

INTERVIEW

PHYSICAL EXAMINATION

PHYSICAL EXAMINATION

DISCUSSIONDECISION

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

DISCUSSIONDECISION

DISCUSSIONDECISION

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 BYESAYING GOOD BYE

INTRODUCTION

INTERVIEW

PHYSICAL EXAMINATION

DISCUSSIONDECISISON

GREETING

DIFFICULT SITUATIONSDIFFICULT 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!