The communication and interaction with patients can be seen form many angles. Generally the practitioner enters a critical situation where bad news is to be conveyed. That is the most critical situation that requires delicacy knowledge of psychology and the patient's surroundings. Effective communication is also critical in gaining the patient's trust and confidence. It is important that the medical professional consider the various elements that ought to be present both as qualities in him or her, and also the intelligent way of communication with patients from varying backgrounds needs and disabilities. The communication with the supporters, families of the patient also form a part of modern medical treatment. Ann Faulkner in the ‘ABC of palliative care: Communication with patients, families, and other professionals,' says that in the case of a life threatening situation or an incurable disease, the medical professional can expect a reaction when the news is conveyed that could trigger a series of reactions which could be emotional, denial, collusion or difficult to answer questions or a batch of all these. The reactions can come from the patient or from his or her well wishers. In this context we must ask the question what the patient expects from the doctor. Most patients' complaint revolves around the inefficiency of the doctor's communication. Patients want frequent information about their condition in a manner they can understand. They also need guidance about the fallout of the disease or its treatment, like pain management and after effects. The quality of interaction between the doctor and the patient is critical and equally important as the treatment. Studies show that where there was good rapport, patients showed a better inclination to trust and comply with advice thereby making the cure faster; Good communication is also a good palliative.
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Formerly patients were satisfied with mere direction and counsel. To day, doctors cannot assume such a state. The reason is that doctors have to understand that patients are well informed, and have access to information from the media and well educated friends and family. The patient is just like a consumer in the market. Researcher Kaplan proved that patients quit the doctor who did not have proper communication skills. It is therefore very important for the doctor to learn communication skills with patients. Medical educators must focus on training the students into dealing with the communication, empathy and gestures with patients. Ethnic considerations like the country of origin and the personal challenges of the patients ought to be considered. For a dentist, the communication with the patient takes a very important seat in his or her skill forum because of the nature of the profession. The dentist ought to be able to ease the patient and allay their fears and make a dental job painless and almost easy to bear. The dentist ought to allay the inherent fear of the drill by his empathy, assurance and easy communication with the patient. For that the dentist ought to understand the cultural diversity, feelings and the best way of communication with the patient.
Jeremy Jacquot of the UCLA Trust gives out the basics of communication and its results in his study and it is stated by him precisely as: ”In the dentist-patient relationship, trust comes from the assurance that personal information will be kept confidential, that procedures are in the patient's best interest, and that patient autonomy is recognized.” Trust is defined as a mutual understanding between the patient and the doctor who are communication in the same level. The patient prefers a doctor, particularly a dentist who shows humanitarian and compassionate attitudes to them, rather than a mechanical and business like attitude. The dentist who takes great pains to communicate and make his patients at ease and shows them that he cares is popular. Communication need not be just about the patient's condition and malady; it can also and must be to some degree social and situational in relation to the patient's life. About his environs, family and even mundane things he is interested in. Communication and presence of humanitarian treatment has been shown to create a lessening of apprehension and anxiety in the patient, which transforms to the patient feeling less discomfort which is attributed to the skill of the doctor and his efficiency. Jeremy Jacquot points out that the most important aspect of communication is based on the cultural background of the patient and the respect of the doctor for those cultures and his understanding of the nature of the culture. Different cultures have different values linked to health and how they ought to be treated. Some cultures like the
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Dentist Rachel Green gives ten thumb rules of communication for dentists which will help them communicate better. A) First decide with your patient what subject he is interested in a conversation. For example some like TV and therefore probe their interest in various programs. Some one may not like to talk but watch TV. So the physician first assesses his patients type and offers that which his interesting to the patient as a starter. B) Avoid talking to patients when their mouth is being probed, or when it is full. That is obvious because they cannot reply and become frustrated. C) Include something of the patient in the conversation: ‘you know John, (Name) or ‘our SUV (common interest) id better than the jaguar- etc.' D) Observe some minutes of no conversation. There must be periods of silence when you work, other wise the patient will become nervous about what you are doing. Is this person attending to it properly is what they will think. It is also a non verbal communication. E) Avoid controversial topics like politics or religious debates which can get the patient at right angles and make him despise you. Apt subjects are hobbies, pets, cars movies and the like. F) Don't answer your own question. Observations like ‘Isn't it cold? Should leave place for an answer.
Adding ‘It sure is' by your self closes the conversation. G) Things like TV, and displays ought to be kept where the patients can see it without much effort. This is important because it engages their attention. Posters are a communication medium that can effectively convey information and also boost your image. H) Always ask for patient feedback and follow them up with question over phone even after they left for sometime. This will build confidence and communication with them and the doctor will be seen as someone who is caring. I) Remember the patient's history and be up to date on the patient's previous visits. You can get the help of modern technology for this. You can use databases to store details of the last visit. They will be stumped when you ask about the pet dog after a year of their visit and recall what you were about last. A patient who does not need to repeat his history to the doctor will automatically become the doctor's admirer. J ) Get to know all the patients better. Explore the relationships and try to get their opinions of your performance, and suggestions regarding improvements to your workplace, chairs, furniture etc. Involving the patients into some of the decisions about your environment enhances their involvement with your operations. These percepts if strictly followed are a sure way of getting patient trust and opening up communication and better prospects.
A physician who is honest and communicates with sincerity keeping in mind the above principles will succeed in assuring his patients and getting their trust. It also paves way for a long term relationship between the doctor and his patient. This is very important where bad news is to be conveyed. The relation ship between both in the case of a major surgery, or painful treatment that involves suffering will be largely dependent on the interaction of the physician and the patient. To neglect this important aspect of the practice is not only to be ineffective but also to become mediocre or even unpopular. Most patients' complaint revolves around the inefficiency of the doctor's communication. Patients want frequent information about their condition in a manner they can understand. They also need guidance about the fallout of the disease or its treatment, like pain management and after effects. This aspect is so important that the University of Florence has started the AMICUS project in 2003 to formulate an interdisciplinary method of educating doctors and medical practitioners the art of communication.
Matteo Paoletti et al in the essay ‘Building a Bridge for Communication between Patients, Family Doctors, and Specialists' say that “ICT technologies must tackle this challenge by providing the means for fast communication and consulting services between the chronically ill, the general practitioner and the hospital specialist.”. It is with this aim that the project sought to create a method in line with the objectives of the World Health Organization (WHO) to over come interracial and international barriers in communication and development of communication devices that helped link doctors to one another and also provide for all round communication with the patients and all round access by the patients. Experiments in this regard are underway at the COPD (Chronic Obstructive Pulmonary Disease) at Florence. we now understand the importance of communication and the role it plays in the life of a physician and also the importance of identifying with the patient and empathizing with them. We thus conclude that A communication ought to be based on the cultural background of the patient and the respect of the doctor for those cultures and his understanding of the nature of the culture and it must involve the patient with the doctor reaching out at the level where the communication is in the level of the patients understanding. A friendly and open attitude is very necessary. It is possible for doctors to remember their patient's history faster and in a more convenient way today because software and better communication tools are available to store data and also for interpersonal communication. Today it is just a question of a doctor following up with his patient on his mobile. With the innovations in communication, the task of keeping social contact is a personal choice of the practitioner. The doctor with better people skills wills triumph over the doctor with higher qualification and knowledge if that person has no communication skills.
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