DOCTOR-PATIENT
COMMUNICATION
DR MARUTLA
Introduction
• Human communication is the process of creating
meaning between two or more people.
• It is to transfer Ideas - Information - Norms- نماذجValues -
Attitudes
Why do we communicate?
The importance of communication:
• To make people understand us and to understand
others.
• To make us accepted.
• To undertake something.
• To strengthen the human relationships and social links.
• To spread the human spirit of friendship and
cooperation.
Why do we communicate Cont.
• The purpose of communication is transferring
information, creating understanding, and influencing
behaviour. It should result in the expected actions /
performance.
ADVANTAGES OF VERBAL
COMMUNICATION
•
Is informal
Is quick and saves time
Is more forceful
Coveys shades of meaning
Direct response and reaction is possible to see
Promotes closeness
Feedback, clarification and correction is immediate
More effective with groups
What is communication?
•Communication is the response you get
when you send a message, regardless of
YOUR intent.
What is COMMUNICATION Cont.
• Communication is the process of exchanging ideas,
information, facts, opinions, feelings or emotions,
between persons.
• ART OF CONVEYING WHAT WE WANT
• MAKING OTHERS UNDERSTAND WHAT WE HAVE IN OUR MIND
THROUGH SOUNDS, WORDS, GESTURES OR PICTURES
• SENDER MEDIA RECEIVER
MESSAGE CHANNEL MESSAGE
FEED BACK
Ideas Speech Listening
Information Writing Reading
Facts Symbols / Observing
Gestures
Knowledge Interpreting
Graphics
What is communication
• Communication is an interaction between two individuals in the
transfer of information.
• It is important because it is the front-line safety net at the front-
lineof patient care in critical and urgent situations.
• It is also important because effective communication, or the
lack of it, has been strongly linked to adverse events and
medical errors.
Benefits of communication in the medical
field
• To improve patient compliance
• To improve patient satisfaction
• To improve health outcomes for patients
• To improve the accuracy and efficiency of the consultation
and hence is .more rewarding for the doctor
Elements of communication
• Sender Who sends the message - doctor, nurse etc
• The Message What Ideas, Information, Feelings
• The Channel How Means of message transmission. Face-face,
group discussion, radio, newspaper, conference, T.V, internet
• The Receptor To whom The person to whom we talk or the one
who receives the message.
• The Feedback With What Effects The information or the
reaction given to the receptor
Let us think
• You perform a health education program in x village for
family planning to increase the users of pills.
2 weeks after your visit there was no increase in pill
users
why?
Why is communication so important in clinical
settings?
• Affects the entire team’s functioning
• Shared Responsibilities – M.D.s, R.N.s, Therapies, Consults, Ancillary
services, etc.
• Establish diagnosis and plan procedures and therapy
• Patient outcomes depend on accurate transfer of information from
one care-provider to another in the right manner and at the right
time in the right context.
What challenges effective communication
• Effective communication is challenged by the co-
existence of
intra-personal (what exist within your mind),
Interpersonal (relating to relationship between
people) and
organizational dynamics.
Intra-personal Barriers
• Cognitive load – too much to think about
• Competence – Are you knowledgeable and are you able to apply
that knowledge?
• Confidence – Your level of confidence can either be inspiring to
others or dampen their enthusiasm
• Stress – Can be internal, or due to external factors (financial,
matrimonial, familial, etc.)
Inter-personal barriers
• Past experience with the sender of the message
• Conflict between the two – sender and recipient
• Language and cultural differences between two health
providers or between the provider and the patient
• Gender issues
• Hierarchy issues
• Misinterpreting non-verbal communication
Organizational barriers
• Production pressures
• Resources to do your work effectively – human resources,
supplies, equipment, etc.
• Diffusion of responsibility – Having too many Individuals
responsible for giving instructions.
• Authority gradient – can either be a boon or a bane,
depending on where you are in relation to the hierarchy
• Interruptions, distractions, etc. can hamper effective
communication and even prevent smooth transfer of
information, putting the safety of the patient and/or provider at
risk.
What to do if two communicators
disagree?
• RESOLVE CONFLICT within the framework of the
guidance provided by the hospital
• ADVOCATE for the patient or the health colleague
Communication Cont.
Structured
Communication
Strategies
What can hinder communication?
At the source or sender level
• Does not know or convinced with the subject.
• Cannot communicate the message.
• Does not formulate clearly the objectives or the message.
• Does not choose the suitable language of the receptor.
• Does not change the tone.
The communicator must :
• CLEAR= C: Clarify L: Listen E: Encourage A: Appreciate, R: Reassure
• Do not give orders. Do not attack. Do not be aggressive
or ridiculous
At the message level
• Difficult words.
• Is not of interest to the receiver.
• Is not related to the stated objectives.
• Unclear, confusing.
• 3- At the channel level
• Noise.
• Not adapted to the message transmission.
• Not accessible to the receptor.
At the receptor level
• Indifferent to the message.
• Could not decode (understand) the message.
• Cannot receive the message.
• Poor listening conditions.
• 5- At the feedback level
• Feedback not well prepared.
• Limited time.
• Selection of those who respond.
• Question poorly formulated.
Assertive communication style
• To get the attention of the person you are talking to –call
him by name
• Be confident, clear and to the point
• Always be respectful
• Communicate with the goal to resolve conflict
PRINCIPLES OF GOOD VERBAL
COMMUNICATION
Principle of clarity
Principle of integrity
Provide Feedback
Use of body language
Principle of empathy
Behaviour that discourages Communication
Judging : "You are wrong"
Superiority : “I know better”
Certainty : "Don't confuse me: I have made up
my mind".
Controlling : "Let me tell you, how.…”
Manipulating : "I am really counting on you; but if
you cannot handle it”
Indifference : "What you say is of no matter”
