Chapter 1: Patient Communication

INTRODUCTION

1.1 INTRODUCTION TO PATIENT COMMUNICATION

Communicating with patients and other healthcare providers is the most important aspect of patient care. Communication is a skill that can be learned and improved over time with practice. Good patient communication facilitates the examination process, improves the accuracy of diagnosis, improves patient compliance, decreases patient complaints and malpractice claims, and makes every patient encounter more enjoyable for the clinician as well as for the patient.

There are many opportunities to demonstrate good patient communication throughout the patient care process, and it starts when the patient first calls to schedule an appointment. All staff need to know that the patient is the most important person in the care process, and they must be treated with dignity and respect. Early demonstration of good communication skills is important and should be continued throughout the examination process until the patient leaves the office.

This chapter starts by highlighting the importance of patient privacy and how it should be respected throughout all patient care communications. Other communication opportunities presented in this chapter include acquiring the case history, presenting the findings to the patient at the end of the examination, presenting the case to colleagues or to an attending doctor, developing an assessment and plan, writing consultation and/or referral letters, reporting abuse, and writing a prescription for medication.

Case history is the most important procedure in the entire repertoire of examination procedures, and it is one of the most difficult to learn. History taking can be mastered only after the acquisition of a broad base of knowledge and after years of clinical experience. An experienced and knowledgeable clinician often can determine the diagnosis from the history alone. Conversely, the novice is frequently overwhelmed by the information gathered in the case history and is rarely able to effectively gather and use the relevant information in the diagnostic process. It is beyond the scope of this book to provide sufficient information for a novice clinician to conduct a proficient, comprehensive case history. Rather, the components of the case history are presented to illustrate the main parts of a history for a typical primary care examination and for a typical follow-up examination.

The case history is usually conducted at the beginning of the examination and is the time for the clinician and patient to become acquainted. The clinician must present themselves to the patient as a caring and empathetic individual if they expect the patient to be forthcoming about their problems and to comply with advice given. At the same ...