Keys to good patient-physician communication

The patient-physician relationship is a fundamental pillar of healthcare, and shared decision-making is essential to ensure that patients are actively involved in their own care. It is even more important when dealing with long-term or chronic diseases or conditions.

This is why we have compiled a list of the most common problems in doctor-patient communication and made some recommendations on how to communicate effectively when making decisions with patients.

Common problems in patient communication

• Language and cultural barriers: Differences in mother language can make it difficult for the doctor and patient to understand each other and to explain pathology and options in terms that are too technical or complex.
• Complexity of medical information: Medical information can be complex and difficult to understand for patients who do not have a medical background. The use of medical jargon can contribute to patient confusion and frustration.
• Lack of time or privacy: Medical consultations are often short and tightly scheduled, which may limit the time available for detailed and complete communication, tailored to the individual and with sufficient time to check for full understanding of the message. Lack of privacy may also make it difficult for patients to feel comfortable sharing personal information or asking sensitive questions.
• Strong emotions: Fear, anxiety, shame or sadness, and even acceptance or non-acceptance of the new situation can affect a patient’s ability to communicate clearly and effectively.
• Power inequalities: The doctor-patient relationship may be marked by a perceived unequal power dynamic, which may make it difficult for the patient to feel comfortable asking questions or expressing disagreement.
• Biases and stereotypes and nonverbal language: Unconscious biases or stereotypes can influence the way we interact and communicate, not only verbally but also subconsciously.
• Lack of continuity of care: Lack of continuity of care, with different doctors seeing the patient, can make it difficult to establish a trusting relationship and effective communication, sometimes forcing the patient to repeat information and increasing the risk of misunderstandings or omissions.

Recommendations for effective communication in decision-making

• Clear and direct communication: It is essential to establish clear communication adapted to the interlocutor. Understandable language should be used and tools or information should be provided to help the patient understand their situation and the options available to them (infographics, brochures or educational materials).
• Make the patient feel involved in the decision-making process: the strategy for managing the disease should be the doctor’s decision, as he/she is the person who is prepared to seek the most beneficial options for the patient, based on scientific criteria. In any case, it is advisable to seek the active participation of the patient in the decision-making process, taking into account their lifestyle, needs and preferences, as this encourages their involvement and ensures greater adherence to treatment.
• Provide balanced information: Tailoring information to explain to patients what treatment options are available to them, including benefits, risks and available alternatives, allows patients to fully understand their situation and their health. Their concerns should also be answered fully, simply, honestly and objectively, even if the questions they ask are uncomfortable or difficult
• Active listening, showing interest and making sure that what is being explained is understood will make it easier to raise all the questions necessary to make the most appropriate decisions. Ensuring that the patient understands what is being explained by asking open-ended questions or other options is also highly recommended.
• Respect patients’ individual circumstances and beliefs: sometimes, even when we know that the medical recommendation could be different, we need to respect the circumstances, beliefs or other situations that may lead a patient not to want to follow the proposed clinical strategy. Patients are specific individuals with specific circumstances, which may change over time.
• Support the patient emotionally: Giving emotional support and showing empathy helps patients to cope with difficult decisions and/or situations. The relationship should be friendly, accessible and respectful, showing the patient that the healthcare team understands how their condition affects all spheres of their life. It also builds a more trusting relationship with the team of healthcare professionals working with the patient.
• Continuity of communication: especially in long-term or chronic pathologies, continuous communication throughout the treatment process is essential. Hence the importance of planning and agreeing on follow-up visits. It is advisable to facilitate an environment where patients feel comfortable sharing their concerns and updating information as needed.

By following these recommendations, healthcare professionals can strengthen the partnership with their patients, promoting informed decision-making that respects the individuality and needs of each person.

There are multiple benefits to be gained from following all of these recommendations for good patient-doctor communication:

• There is greater adherence to treatment: If the patient has a good understanding of his or her diagnosis, treatment plan and expectations, he or she is more likely to follow medical instructions.
• There is a reduction in errors and complications, whether due to misunderstanding, omission or disagreement.
• It reduces the number of unnecessary tests and procedures by ensuring that the physician has all the relevant and up-to-date information needed and that the patient understands the risks and benefits of each option.
• Improves the quality of care provided and therefore better clinical outcomes are achieved.
• Increases patient satisfaction: Patients who feel listened to, understood and respected have greater satisfaction with their medical care and are more likely to follow the indications received.
• Patient trust in the medical team is strengthened and vice versa.

Ultimately, greater efficiency in the healthcare system is achieved through effective communication, where the patient speaks with confidence and the physician listens attentively, making it possible to reduce the time and resources needed to provide higher quality care and better clinical outcomes.

REFERENCES:.

• Patient Communication: Practical Strategies for Better Interactions; SHANNON J. VOOGT, MD, KELLI PRATT, DO, AND AMBER ROLLET, MDFam Pract Manag. 2022;29(2):12-16 Patient Communication: Practical Strategies for Better Interactions | AAFP
• Maguire P, Pitceathly C. Key communication skills and how to acquire them. BMJ. 2002 Sep 28;325(7366):697-700. doi: 10.1136/bmj.325.7366.697. PMID: 12351365; PMCID: PMC1124224.