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Doctor-Patient Communication (3.4)

Doctor-Patient Communication (3.4) - Doctor-Patient...

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Doctor-Patient Communication: Opening Visits and Dealing with Unmet Concerns Introduction The phase structure of acute visits (random visits; not regular or follow-up) ( Extract in outline) o Opening o Problem presentation The patient telling the doctor what he thinks is wrong o Information Gathering (doctor asks questions) History taking Physical Examination o Diagnosis o Treatment o Closing The phase of problem presentation o Normally initiated and terminated by physicians with questions o Only phase where patients are given license to present their problems in their own terms A space for patients’ self disclosure of not only symptoms, but fears, concerns, worries, etc. o The importance of ‘complete’ presentations Can improve physicians’ diagnosis and treatment Can reduce patient’s blood pressure Reduction of stress Can increase patients’ satisfaction Which decreases their likelihood of suing for malpractice Which decreases “doctor shopping” Which increases their likelihood of following doctor’s recommendations My Interest: Does the format of physicians’ opening questions affect the nature and extent of patients’ problem presentations? ‘Informing’ is constrained by norms/rules o When patients present problems, they inform doctors about their problems o When informing , there is a norm/rule Rule 1a: Don’t inform people of things you presume they already know
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