Patient Communication: A Thoughtful Process

Editor’s Note: This is the first in a series of articles focused on effective communication with patients.

Physicians face several important considerations when communicating with patients in the exam room. First, you have to delve into the patient’s history and assess the ability (or lack thereof) he or she brings to the encounter. Then, you assess the patient’s willingness to engage in the encounter. Being attentive to the patient’s verbal tone, nonverbal signs, and level of participation will provide useful clues to assist this assessment.

What the Words Mean
All physicians are occasionally faced with a difficult patient. In some cases, a patient may take a combative or argumentative stance and simply negate what the physician says. Such a “challenging” patient might insist on arguing with the physician’s diagnosis or opinion using information found online. The “passive” patient might nod and agree with everything the physician says, and the “evasive” patient might keep circling the reason for the visit without ever defining it. These are all clues that will help you determine how to successfully interact with the patient.

Translating Body Language
If you walk into the exam room and encounter a patient who is sitting with arms crossed, head tipped back, and eyes closed, what is the patient telling you? Such nonverbal presentations can be difficult to interpret.

To understand body language, you need to start with who the patient is. Is she a pregnant 27-year-old, 26 weeks along? Is he a 52-year-old construction worker with a history of worker’s compensation claims? What is the reported chief complaint? Even consider what time of day it is. Build a clinical and personal context around each patient in order to understand what he or she is trying to tell you.

Always link your evaluation of nonverbal communication to verbal cues. One straightforward approach is to simply ask about the patient’s posturing. Placing the posture in the context of the tone and content of the patient’s verbal response will be more enlightening than either form of communication considered alone.

By making your patient interactions truly thoughtful rather than simply routine, you create a more meaningful physician-patient relationship and more completely meet patient expectations.

For more information on patient communication, contact the MMS Physician Practice Resource Center at (800) 322-2303, ext. 7702.

– Adam Shlager

Look for Part 2 of this series, “Hearing through the Patient’s Ears,” in an upcoming issue of Vital Signs.