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Chapter 4 interacting with patients
7. Principles of patient clinician communication
7. Principles of patient clinician communication
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Doctor Patient Communication
The main purpose of the medical interview is to collect historical information that can be used to make a diagnosis of the disease and to understand the patient’s problem. (Henderson, 11) This is the beginning of the physician – patient relationship. The interview generally begins by the doctor greeting the patient, introducing himself/herself, and defines his/her professional role. Common courtesy dictates that the physician learns the patient’s name and refers to them with the proper title. Last name is proper for adults, while the use of the first name is comforting to children.
The physician inquires about how the patient is and begins the process of finding out what is wrong with the patient. The first thing that the doctor does is to put the patient at ease and to make them as comfortable as possible. The physician should begin the conversation with an open – ended question, such as, “How are you feeling”. The physician then encourages the patient to mention all of the ailments that they are experiencing. This is when the physician can learn the most about the patient’s personality and environmental influences. It is important for the doctor to be attentive and take good notes. The doctor explores in great detail the time of the ailments and the severity. The physician inquires about the patient’s past health and any family history that is of relevance. The physician then checks the accuracy of all the data and details collected to date and informs the patient of the next step in the process, the diagnosis. It is important that the patient does most of the talking throughout the interview, so that the doctor can elicit all...
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...n – Patient Communication. Springfield, Illinois. Thomas Publishing.
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Street, Richard, MD. (1992). “Analyzing Communication in Medical Consultations: Do Behavioral Measures Correspond to Patient’s Perceptions?”. Medical Care, 30, 976 - 987
Wilkinson, Emma. (2000). “Knowledge and Communication Difficulties for Patients With Chronic Heart Failure”. British Medical Journal, 96, 77 – 82.
Montague and Asan (2013) did a field study where 100 patients’ ages 18 through 65 were observed and video recorded during their visit in a primary health clinic. The researchers wanted to see how much communication and eye contact the physicians would do with their patients when using paper charting compared to using computer charting in the EHR. The results of the study showed that physicians paid more attention to the EHR on the computer then they did their actual patients 46.5% of the time and 79% when they used paper charting (Montague & Asan, 2013). The studies showed that EHRs could hinder communication between patients and their
Effective communication between patient and clinician is an important aspect to patient care. Proper communication has a direct positive impact on patient care and adversely poor communication has a direct negative impact on patient care. I will define the seven principles of patient-clinician communication and how I apply these communications with my patients. I will also describe the three methods currently being used to improve interdisciplinary communication and the one method that my area of practice currently uses. Then, I will explain the ethical principles that can be applied to issues in patient-clinician communication. And Lastly, the importance of ethics in communication and how patient safety is influenced by good or bad team communication.
The purpose of the paper is to discuss the activities involved during the evaluation of a patient. Evaluation of a patient can be seen as the process of examining a patient critically. It comprises of gathering and analyzing data about a patient and the illness (Allan, 2012). The core reason is to make judgment about the disease one is suffering from. Such judgment will guarantee proper treatment and diagnosis. Typically, gathering of information from the patient is the role of nurses while making judgment and prescription is the doctor’s role (Jacques, 1988). In any case all practitioners are required to know how to evaluate a patient.
Communication is cited as a contributing factor in 70% of healthcare mistakes, leading to many initiatives across the healthcare settings to improve the way healthcare professionals communicate. (Kohn, 2000.)
the patient's life and feelings to get an understanding of what the patient goes through on
The ability of a medical practitioner to elicit a sound and thorough chief complaint and history is essential in treating patients. During the first encounter with the patient, medical practitioners should be able to treat based on the information the patient provides. On December 13, 2013, the Physician Associate class of 2015 had the opportunity to interview standardized patients. This encounter was videotaped for self-analysis. I was able to reflect and improve on interviewing skills from watching my own patient interview. My critiques and thoughts are delineated in this essay from which I hope to improve upon.
As a result, I always felt that I am actively participating in patients’ care. She allowed me to perform patient examinations most of the time and encouraged me to build up a good rapport with the patients. I think my past experience and medical knowledge was helped me lot during the history taking because I was able to go through history taking in a systematic manner and at the same time I could think of possible differential diagnosis. Furthermore, working in a medical clinic as a physician assistant also helped me a lot because one of the responsibilities delegated to me is taking patients history, however, this time it was different that I had to work out and actively think about a possible cause for patient concerns. The weakness I observe during history taking was sometimes I am little quick that might hurt the doctor-patient relationship, So, I am planning to improve my listening skill with less interruption to patients, I believe that might help the patient to express their concerns freely. Also, I am determined to listen to patients concerns in a non- judgemental manner to get the unbiased clinical
Initially, I spoke to an advisor, whilst at home, who asked a set of automated questions to assess my symptoms and decide the best course of action. Although this was an uncomfortable process, as it was something I had not experienced before, the advisor was patient and understanding (Finkler, 1991). The language used by the advisor was easy to understand from a non-medical perspective and she took her time to explain the information covered. This improved my confidence in the process, but also made me feel as though I was taken seriously and would receive the correct advice. In contrast, when I spoke to the Doctor over the phone there was a noticeable change in terminology and the general flow of conversation. The doctor rushed through the conversation using medical terminology and offered no explanation for his decision. During a medical interaction, it is important for the patient to be confident that the professional is listening and taking their issues seriously as in order for health care to be effective the patient needs to have confidence in the health professional (Staum and Larsen,
This is based on the concept of the person, and the important dignity and equality of all human beings, that the notion of patient rights was developed. In other words, what is owed to the patient as a human being, by physicians and by the state, took shape in large part thanks to this understanding of the basic rights of the person. Another form of patients’ rights are that of communication, having an open and honest way to communicate with you doctor and or nurse. According to the Medical health journal “Patients have a right to know their past and present medical status and to be free of any mistaken beliefs concerning their conditions” it is in my belief that many patients have the tendencies to believe what doctors tell them about themselves ex: when the doctor tells you that you haven’t stopped smoking when in reality you have stopped three months ago. A patient has the right to tell the doctor about his or her bodies and the doctor has to be able to understand and listen what is being told to
(2000) and can be used to assist communication as it gives a clear structure for future consultations. The first step is setting up the interview which includes arranging for privacy and making sure that the patient is comfortable especially if sensitive topics will be discussed. This establishes patient rapport and allows the patient to be able to open up to the physician. The second step involves addressing the patient’s perception. I think this is an especially important step in ensuring patient centered care as it is the perfect opportunity for doctors not only to understand the patient by allowing them to talk, but also show genuine care by listening intently to their concerns.
Hello my name is Nikita Kharbanda, I am a student of Amity University, I am pursuing masters in psychology, and I am doing a research on people in the medical profession. And I am here to interview Dr. S and Dr. A. Today is 29th of January and the time is 1:03 pm. We have three people in the room, sir maam and me. And I would be calling out a few important things that are, topic of my case study is “Professional journey of two couples in the medical profession” I shall interview you and record your answers for research purpose, your identity will be kept a secret and all your personal and professional details will be used in the analysis and shall not be revealed. Can I go further? NK
"A Guide to Taking a Patient's History” is an article published in an August 24th, 2007 issue of Nursing Standard. Written by H. Lloyd and S. Craig, the process of taking a history from a patient is outlined. Many aspects pertinent to obtaining a sufficient health history are discussed. In addition to providing a framework for completing a thorough health history, guidelines and interview techniques are explored.
One might argue about the patient’s competence to give a review about the treatment and interaction with healthcare clinicians and staff.
While taking care of my patient on the cardiothoracic intensive care unit, I assisted another nurse who was helping her seventy-one year old patient ambulate to promote circulation and decrease the patient’s chance of developing pneumonia. It also helps the patient to build strength and confidence after such a major surgery like this patient underwent. This patient had come in with non-ischemic cardiomyopathy and had a history of cocaine and alcohol abuse, atrial fibrillation, mitral regurgitation, and hypertension. She had a left ventricular assistive device placed, and ten days after the device had been placed, she was diagnosed with H1N1, had a tracheostomy performed, and was placed on the ventilator. Since she had to wear a mask when outside of her room and had a tracheostomy, it was really difficult to understand the patient’s needs, and this was very concerning to me.
From state and federal levels, the healthcare industry has come a very long way, experiencing changes along the way. The development of advanced technology that has enhanced the quality of healthcare delivery systems will help all patients to be able to benefit. Doctors are able to access patient records at a faster rate and respond to their patients in a much more timely fashion. E-mail, electronic transfer of records and telemedicine will give all patients and physicians the tools needed to be more efficient, deliver quality care and deliver quality telecommunication at a faster pace than before.