Patient-centred communication: The most desirable approachA patient-centred communication focuses on patients’ feelings and perspectives; thus, is often the most effective approach in promoting patient satisfaction. This is especially important in patients with serious illness.
A survey published in the British Medical Journal revealed that patients would prefer doctors who are willing to listen, explore and understand their thoughts, their worries, their feelings as well as their expectations. In addition, they are always seeking clear explanations from the doctors about their problems as well as the treatment options.
Doctors should use less complicated wordings when conveying medical messages. Less jargons should be used. A good doctor should also constantly check with the patients on their understandings regarding the explanations and instructions – in order to make sure information is successfully conveyed to the patients, and they are comfortable throughout the communication process.
In the survey, researchers also discovered that patients are more than happy to have a doctor who is always interested in his or her ideas, and is willing to discuss with them about their ideas, problems and treatments.
Patients who are worried about their health are also found to be eager about health promotion. They need advice from doctors to reduce the risks of illness and stay healthy in the future.
Use of computer impairs face-to-face communication; less favourableOwing to the advancement in technology, electronic devices have been deployed as a tool to manage health records. This is of recent concern that it might impair doctor-patient communication. This is especially the case in patients with chronic diseases such as cancer, because they often have emotional issues, which require doctors to talk to them face-to-face.
A recent survey which involved rating doctors in a face-to-face consultation and consultation using a computer found that 72% of the patients with advanced diseases favoured face-to-face interaction. They opined that doctors in face-to-face communication are more compassion, have better communication skills and professionalism than the doctors in consultation using a computer.
"We know that having a good rapport with patients can be extremely beneficial for their health," asserted Dr Ali Haider, an assistant professor at the University of Texas MD Anderson Cancer Centre. "Patients with advanced disease need the cues that come with direct interaction to help them along with their care."
According to a Northwestern Medicine study published online in the International Journal of Medical Informatics, consultation using a computer could affect the eye-gaze patterns of the doctor and the patient. Both doctor and patient would spend most of the consultation time looking at the computer screen. This could subsequently impair the doctor-patient communication.
Lacking face-to-face interaction, doctor might miss out the patients’ non-verbal cues. As they are already focusing on the computer screen, they might not be able to recognise patients' problems and feelings from their speech pattern, facial expressions and body posture. According to Enid Montage, first author of the study, “It’s likely that the ability to listen, problem-solve and think creatively is not optimal when physicians’ eyes are glued to the screen.” Thus, impairing effective doctor-patient communication.
Another study published in the Journal of Participatory Medicine strengthens this point, concluding that eye contact is more preferred by patients. The study revealed that patients viewed doctors who make a lot of eye contact as being more empathetic – which subsequently increases the patients’ trust in them.
Doctors who are being empathetic would more likely to have their patients return to their care and adhere to their medical advices. Their patients would also more likely to seek for their care whenever they need.
A contrary viewpoint: Electronic health records enhance communication
As opposed to the studies which prefer face-to-face communication over electronic health records, a viewpoint published in the 12 June issue of the Journal of the American Medical Association had postulated an enhancement in doctor-patient communication with the use of electronic health records.
The authors supposed that electronic health records can be a mean to encourage doctor-patient collaboration as well as enhancing patient activation during the consultation. However, no data is available to support this viewpoint. Thus, future empirical studies to explore the potential of electronic health records in enhancing patient activation are required.
Taken together, a doctor should make optimal use of both verbal and non-verbal cues, as well as electronic devices during their communication with patients, so as to achieve effective medicinal communication. MIMS
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