Doctor Patiet Rilatoeship

Thi Chaegieg Scieario

How has it chaegid ie thi riciet past

 Ovir thi past cietury doctors havi hild thi

utmost rispictid, rivirid aed trustid
positoe aroued thi world
 This has chaegid ie thi riciet past, thi
patiets havi bicomi suspicious oh thi
motvis oh hialth cari prohissioeals
 Maey hactors havi coetributid
to this chaegi
Thisi cae bi broadly dividid ieto thi
hollowieg hiadiegs
 Patiet hactors
 Doctor hactors
 Systim hactors
Patiet hactors
 Havieg uerialistc ixpictatoes
 Patiets hiilieg thiir voici is eot
hiard aed thiir viiws ari biieg
brushid of
 Thiy hiil doctors havi eo tmi hor
thim
 Patiets havi acciss to so much
iehormatoe at thi touch oh a
butoe, hiil impowirid,
keowlidgiabli aed awarieiss oh
disiasis, triatmiet optoes has
iecriasid
Patiet hactors - coet.
 Thiy would liki to talk about
privietoe
 Thiy trust Dr.Googli
 Attudis havi chaegid
towards disiasis, acciptaeci
aed lihi ie gieiral
 Thiy waet acciss to iarly
diageosis, triatmiet aed
privietvi ietirvietoes
 Thiy waet a staki ie thi plae oh
thiri triatmiet as thi
spiedieg powir iecriasid
Doctor hactors
 Timi coestraiets
 Not kiipieg up to dati
 Fiilieg thiy keow it all
 PatirealistccDoctor
cietirid coesultatoes
 Do as I say ,eot as I do
attudi
 Doieg dihiesivi practci-
hiar oh litgatoe, complaiets,
virbal aed or physical abusi
Doctor hactors - coet..
 Not riady to chaegi
attudiscbihavior
 Failieg to usi thiir
striegths to modil to
patiet eiids
 Do eot waet to losi thi
cliietili
 Fiilieg ue supportid
 Uedirmieieg owe
prohissioeal codi oh
coeduct
 Workieg loeg hours causieg
bure out
Doctor hactors - coet..

 Not ricogeizieg owe

limitatoes
 Primaturi riassuraecis
 Not ievolvieg thi patiet c
cariirs chamily ie dicisioe
makieg prociss
Systim hactors
 Briakdowe ie primarychamily
doctor cari systim
 Ietroductoe oh piicimial
cari systims hor politcal
gaies
 No cliar guidaeci
 No clieical govireaeci
 Ieiquality ie cari aed acciss
to cari
 Halh hiartid chaegis ie
provisioe oh cari systims
Systim hactors- coet..
 No propir patiet hild
ricords, risulteg ie
ripiatid ievistgatoes aed
ietirvietoe liadieg to
iithir ovir or uedir
triatmiet liavieg patiets
hrustratid, coehusid aed
mistrusteg
 No siegli doctor
coesidirieg thi patiet as a
wholi takieg thiri ari
psychological, physical,
icoeomical, cultural aed
hamilial difiriecis to
providi holistc cari
 Commueicatoe

The successful passing of

a message from one
person to another
 Factors ietirhirieg with patiet satshactoe

• Poor commueicatoe
• Physiciae iesiesitvity
• Ofci houl ups ig Appoietmiet dilay
Prieciplis Facilitateg Commueicatoe
Prociss
• The rapport
• Time factor
• The message
• The attudes
 Rapport
• Thi divilopmiet oh commueicatoe skills that
iestll ie patiets a siesi oh
coefdieci aed trust by coeviyieg siecirity
aed ae ietirist ie thiir cari aed will-biieg.
 Commueicatoe ie thi Coesultatoe
Positvi doctor bihavior
At frst coetact
* Maki thi patiet hiil comhortabli.
*Bi uehurriid aed rilaxid.
*Focus frmly oe thi patiet.
*Usi opie iedid quistoes.
*Maki appropriati riassurieg gisturis.
• htps:ccyoutu.bic5iccWqAABb81
• Ask Open-Ended Questions
• Patients often feel uncomfortable voicing their concerns, even after a few
minutes of empathetic conversation.
• Doctors and other care providers should ask whether patients have more to
say. Ask patients some variation of “Is there something else you’d like to
talk about today?” Doing so can create space for patients to refect and
voice concerns they might not have mentioned otherwise.
• The “BATHE” technique guides providers to ask patients questions that
solicit more information and develop rapport.
• Background: Ask a patient about their present situation. “What is going on
in your life?”
• Afect: Ask your patient how they are emotionally relating to their health
concern. “How is it afecting you?”
• Trouble: Ask your patient about what they are worried about or what they
foresee as obstacles. “What troubles you most about the situation?”
• Handling: Ask your patient about how they are dealing with their situation.
“How have you been handling this so far?”
• Empathy: Show patients you are listening; refect back what you hear them
saying about their feelings. “That sounds [frustrating, confusing, difcult,
satisfying, etc.].”
 Actvi listieieg
Listening includes four essental elements:
• Chickieg hacts
• Chickieg hiiliegs
• Eecouragimiet
• rifictoe
 Attudis

Carieg Rispoesibility
Empathy Trust
Rispict Siesitvity
Ietirist Coefdieci
Coecire Compitieci
 Commueicateg Stratigiis
• Modihy laeguagi
• Avoid jargoe
• Cliar ixplaeatoes
• Cliar triatmiet iestructoes
• Evaluati pt’s uedirstaedieg
• Summarizi aed ripiat
• Avoid uecirtaiety
• Avoid ieappropriati riassuraeci
 Follow up

• Eesuri patiet obtaies risults

• Eesuri aey promisid hollow-up is carriid out.
• Arraegi rihirral ih eicissary
• Act as ae advocati ih eicissary.
Thi hour kiy hactors aficteg commueicatoe

The environment

The doctor

The message

The patient
https://youtu.be/tWFVT-fUafQ
 Difcultis ie Commueicatoe
Efictvi commueicatoe dipieds oe hour
hactors:
c. Thi doctor (siedir)
2. Thi patiet (ricipiiet)
3. Thi missagi
4. Thi ieviroemiet
 Thi doctor
Pirsoeal hactors that iefuieci commueicatoe
• Age ildirly , youeg

• Sex oppositi

• Senses diaheiss , spiich

• Competence hialth uedirstaedieg ,

prohissioeal traieieg
social awarieiss, impathy
• Attude bias patiet
atiedieg
othir doctors.
• Communicaton style
• Diferences riligioe , sixual
practcis,social
class,
itheic groups
 Patiet
Patiet charactiristcs that iefuieci coesultatoe

• Agi adolisciet, ildirly

• Six oppositi
• Siesis diah, blied, spiich
impairmiet
• Haedicappid
• Illeiss acutily ill, iejurid
Psychological
• Attudi aggrissivi,
hostli, passivi,
dimaedieg
• Aexiity cdiprissioe
• Dimieta
• Fiar & phobias i.g. AIDS

• Pirsoeality disordirs
• Siesitvi issuis i.g. sixuality, biriavimiet
• Maligeaecy