5 Do’s and 5 Don’ts for Good Doctor-Patient Communication

5 Do’s and 5 Don’ts for Good Doctor-Patient Communication

Your choice of words matters. Here’s some ideas on what to say to patients, and how – and what not to say.

There is no point in being a clever, skillful and knowledegeable doctor if you are a poor communicator.

You will make mistakes, partly as the patient will not like or trust you. Why? They won’t do what you ask, and won’t return.

Here are our top tips for improving doctor-patient communication.

5 Do’s

1. DO make small talk

Go to the waiting area and welcome the patient. You can learn a huge amount about the patient’s problem, by careful observation [“90% of medicine” by the way. MyHSN Ed]. What are they wearing? Reading? How do they walk? In pain? Short of breath? Anxious?

Then, when in your room, initially engage in small talk. Greet the patient by name and make eye contact – rather than jumping right into the reason for the visit. Introduce yourself properly and clearly. Wear a easy to read badge.

This is a good opening phrase:

Thanking for coming to see me today. How can I help you?”

2. DO show empathy

Evidence shows that many patients consider empathy the number-one quality of a good doctor.

Showing empathy is as simple as a few well-chosen words. Validate the patient’s feelings and concerns to build trust and rapport.

I understand that must be very uncomfortable for you. Let’s see what we can do to help that problem” Or ..

I hear you. You’re in the right place now. We are experienced in this condition, and will look after you”

3. DO listen actively

Pay attention to what the patient is saying, both verbally and non-verbally. Observation is 90% of medicine [“Yes we have got that now.” Ed] 

Maximise the ‘golden minute’. This is the first minute of the patient telling you about the problem.

Don’t use the computer for the first 1-2 minutes (see below).

4. DO use simple clear language

Avoid medical jargon and explain things in a way that’s easy for the patient to understand.

Words like ‘refractive,’ ‘accommodative,’ or even ‘ocular’ are just not words that register with most people.

Speak to patients in a respectful and non-judgmental tone.

[“Follow the KISS principle = keep it simple stupid (you!)” MyHSN Ed]

5. DO consider a range of patient education methods

Write things down. They are frightened and will only remember half of what you say. But, which half? The more important one? The less?

It is good practice for the patient to leave with a note from you, in the form of a ‘hand written contract’ – i.e. please will you do this (1-2 big things, not 7), and I will do that. And this is how to contact me if you have any issues.

A picture is worth a 1000 words. You don’t have to be a great artist to draw a diagram that explains a complicated disease or treatment.

Bonus Do’s

• DO Ask open-ended questions. Encourage patients to share their thoughts and feelings by asking questions that can’t be answered with a simple “yes” or “no”
• DO Encourage patient participation. Involve patients in decision-making about their treatment. This will improve outcomes and patient satisfaction
• DO Ask if you addressed all of the patient’s questions. If you have time, end patient visits with the question: “Is there anything else I can help you with today?”

5 Don’ts

1. DON’T interrupt

After you ask or confirm why the patient is there, give the person at least two minutes to talk before jumping in.

Studies have shown that on average, doctors wait just 18 seconds before interrupting a patient.

Let patients finish speaking before responding or asking questions.

2. DON’T turn your back on patients

Your body position and demeanour matter. Is the computer blocking eye contact? Can the patient read it? Why not? It’s their information.

Use the ‘POISED model’ for computer use (see below).

3. DON’T dismiss patients’ concerns

“Don’t worry about that right now” or “That’s to be expected at your age/weight etc.” may seem like harmless comments to you, but to patients these can be interpreted as dismissive or disrespectful.

Note. Chronological age is not a reason to not offer care. Biological age matters. They may have a more active and fulfulling life than you, and be 40 years older. So, it’s important not to say ‘At you age .. ‘ etc. They will think you are dismissing them, or will not try hard enough soley based on their age. You will be their age one day.

Minimising your patient’s concerns is dangerous. If you treat your patients as though their concerns are trivial, they will be unlikely to share important information with you in the future.

Take patients’ concerns seriously and address them in a thoughtful and compassionate manner.

4. DON’T tell stories about your health and illnesses

They have not come to hear about you, or your friends and family. It is about them. Yes, you need to be friendly, but you are not their friend. Saying “Oo yes .. I’ve had that too” is not helpful.

5. DON’T rush the conversation

Especially in elderly people. Show them respect. You will be old one day. Take the time to fully discuss the patient’s concerns and questions.

Bonus Don’t

• Don’t ignore non-verbal cues. Pay attention to body language and other non-verbal signals that may indicate patient anxiety or discomfort.

‘POISED model’ for responsible computer use habits

This has six guidelines.

1. Prepare (prepare, prepare, prepare). The 4 ‘Ps. Or ‘poor planning (leads to) poor performance’. It is worth spending 2-5 mins reading your/other recent letters or notes, chasing recent investigations. They may be coming for the result of these tests.
2. Orientation. Don’t use the computer for the first one to two minutes of the appointment. Instead, set the stage by engaging in dialogue.
3. Information gathering (and data entry). Patients expect you to use the computer at certain times, such as during information gathering portions of the appointment. Failing to enter data into the computer at these times can make the patient feel you are minimising their concerns.
4. Share. Position yourself so you are facing the patient, and the computer is to your side. Allow them to see what you are typing. Patients want to feel like your partner in their care, and patient participation is a key factor in improved outcomes.
5. Educate. Approximately two-thirds of people are visual learners. Take advantage of the screen and visually display the patient’s data while discussing their care. Show them the key information on the computer. Graphs are good for showing trends.
6. Debrief. Use the ‘teach back’ method to ensure your patient understands your care instructions. The computer can be your ally when you are showing them useful patient health information; e.g. good websites, videos, printed information, or interactive tools.