08Nov

How to talk to patients—so they’ll listen

Patients need to pay attention and hear directions. If only they would listen!

Honestly, though, when we say we want patients to listen, what we really want is for them to obey. We want them to comply with doctors’ orders for their own health. So why don’t they?

The reasons a patient does not comply with medical advice is as individualized as the patient is, but there are some different approaches to help a patient act on the directions that you offer on behalf of a health care provider.

For that to happen, a patient should understand how they “own” their compliance with health care directives.

You can help them by:

  1. What you say
  2. How you say it
  3. How well you listen

What you say

What you say matters a lot. Use simple terms. Choose ordinary words rather than medical or anatomical terms as appropriate to help ensure that a patient understands what you are saying. While you may use “owie” with a young child, and “bruise” with an adult, neither may be familiar with “contusion.” Use the word “medicine” rather than “drug.” People associate “drug” with an illegal substance. At the same time, avoid slang terms; not everyone understands them the same way.

After giving directions, ask patients to repeat back to you in their own words what they understand. By listening to them, you’ll be able to fill in the blanks on what they may have missed. Or the process of thinking through the directions may prompt a question.

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Even when they know what to do, sometimes patients are reluctant to ask questions or share their concerns about following the physician order. They might worry that they are bothering you or appear to be questioning the doctor’s knowledge. Or someone who is sick or in pain may not be thinking clearly. Thoughtful questions from you may help surface a problem that you can address. You might ask “As you see a picture in your mind of yourself following the doctor’s recommendation, what might prevent you from doing it?” Or if they have a new prescription, ask if they have a routine already set that they will work the new med into. It’s easier to visualize taking a dosage at morning break and bedtime than simply twice a day. Not sure what questions to ask? Consult with the providers you work with. Then, try out a few with different patients and see what results you get. Over time, you’ll refine your approach and it will become second nature to talk this way with patients.

How you say it

Present your doctor’s recommendations in a way that shows that your practice is collaborating with the patient in their care. You are partners in wellness and health. People respond better to advice and directives and questions from care givers when they understand why they are being advised.

Speak slowly – words can be mistaken if spoken too quickly. Especially over the phone where you cannot see others’ expressions. Speak clearly, not loudly – If someone doesn’t seem to hear, it’s a natural inclination to raise your voice, especially when talking to elderly patients. But that makes it harder to understand what you are saying. Instead, try to enunciate each word. Remember, too, that all humans read body language. Make sure that your facial expression and posture aligns with the words you are saying.  

When possible, use visual aids to help convey a message. Information sheets and written directives reinforce your message. What is routine for you may be brand new to a patient. Try to recall what it was like for you when you were first learning about medical care.

Special considerations for patients with a disability

  • Speak to the patient directly and not only to the caregiver. Give the patient a chance to answer for themselves and then look to the caregiver for additional information if needed.
  • Disabled patients may need more time due to physical or cognitive barriers. Cognitive disabilities require more detailed or simplified instructions.

Adapted from: http://www.physicianspractice.com/patient-relations/how-improve-interactions-special-needs-patients

Special considerations for elderly patients

  • Give them time. If you are impatient, they might shut down. Additionally, some elders don't have the mental capacity to express themselves fully. You might find out something vital to the care of the patient just by spending a few extra minutes with them.
  • Explain things simply. At the same time, you don't want to come across as condescending.

Adapted from: https://www.ausmed.com/articles/communication-skills-for-nurses/

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How well you listen

Listening without judgement means that you hear a patient’s story without judging their word choice, their accent, or their health habits as neither good or bad nor right or wrong. Simply listen for the facts and how the patient experienced them.

Look at the patient as much as possible while they are talking, even though you may need to enter the info into an EHR. Listen closely to what the patient is saying and then repeat in your own words back to the patient what you understand. This allows the patient a chance to confirm your understanding or correct it.

Making the effort to show that you are listening builds trust with a patient, which enhances the process for everyone.

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Keep the lines of communication open. If it’s approved by your office, encourage patients to call if questions arise later. Be sure to point out what number to call or where to send an email. A timely answer to a question now can prevent bigger problems in the future. If a patient can expect a follow up call, let them know so that they are prepared to provide relevant information on the call.

 

So, it turns out that we don’t want patients to “obey.” By communicating respectfully and effectively in the relationship, we acknowledge that each patient is the captain of their own health ship. And only they can decide to comply with health care directives. You are working with them to optimize their health. Rather than “telling them what to do” you are collaborating with them and that’s how patients hear you best.

That is why patient communication skill is a core competency an employer looks for when hiring a registered medical assistant. Because when a medical assistant makes an impact by improving communication, patient satisfaction goes up and that sounds good to everyone involved.

Another resource for effective conversation

  • Workplace Listening Skills Webinar: An AMT webinar offering 1CE credit to help you comply with CCP while learning the process, barriers and types of listening.
  • Crucial Conversations: Teaches skills for communicating when the stakes are high, opinions vary, and emotions run strong.

 

Sources:

Bush, Hillary; Lampert, Lynda; Edwards, Tracy; Hodgkinson, Katherine (2018, June 18). Communication Skills for Nurses. Retrieved from https://www.ausmed.com/articles/communication-skills-for-nurses/

Bahrych, Sharon (2018, May 9). 4 Tips to Better Communicate with Patients. Retrieved from https://www.kevinmd.com/blog/2013/05/4-tips-communicate-patients.html

Staff writer, AMA Wire (2015, June 22). 6 Simple Ways to Master Patient Communication. Retrieved from https://wire.ama-assn.org/education/6-simple-ways-master-patient-communication

Clark, Kendra (2018, September 26). How to Improve Interactions with Special Needs Patients. Retrieved from http://www.physicianspractice.com/patient-relations/how-improve-interactions-special-needs-patients

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