This chapter presents an interaction between the provider and the patient. The patient’s demeanor, tattoos, and piercings had impacted the interaction. The patient’s request for pain medicine changed the provider’s perception of the patient’s complaints. Preconceptions and stereotypes about drug seekers and drug-seeking behaviors affect interpersonal communication and interpersonal relationship development in settings like the emergency department (ED). Verbally aggressive behaviors had impacted the exchange of information. The provider’s willingness to acknowledge the patient’s pain and discuss his or her plans to medicate affects the interaction. Health care providers need to work diligently to keep stereotypes from influencing their perceptions, while at the same time using all the data they can gather to enhance their assessments and decision making. Patients in pain want pain relief, but with drug-seeking patients, especially in urgent care and ED, it can be difficult to assess who needs pain medicine and who does not.
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This chapter helps students, faculty, and health care providers to assess and practice key interpersonal and health communication skills. It discusses case of a 33-year-old stockbroker, who is being treated for hypothyroidism. The new Take-Away Considerations feature at the end of each case study reinforces an understanding of the elements of effective communication. The patient is being started on a new medication and the provider writes for a generic. The patient is concerned about the efficacy and safety of a generic versus a brand drug, but the provider seems to discount her fears, not with information about the Food & Drug Administration (FDA) standards for generic equivalents. Studies specifically have shown major differences in the effectiveness of thyroid replacement hormones, many health plans have very small additional copy for the brand versus the generic for thyroid medication.
Closings of interactions require effective nonverbal behaviors as well as verbal communication. Nonverbal behaviors can be used to communicate to patients that a provider wants to have a collaborative relationship and not an authoritarian, paternalistic relationship. Providers using feedback to clarify what patients or family members communicate and demonstrate that they are listening and assimilating the information they are being given. In the enhanced interpersonal communication, the provider has nonverbally decreased the power differences in the relationship by having the patient remain dressed during their conversation, sitting across from the chief executive officer (CEO) at eye level, and only having the patient put on a gown when it was needed for the examination portion of the visit. The provider takes the time needed to empower and educate the patient, including how long it will likely take to get the results, thereby eliminating that aspect of the unknown from patient’s concerns.
This chapter presents an interaction between the provider and the patient. The provider is predominantly impacting this provider- patient relationship and communication. The provider’s communication in this scenario has affected the information exchange, the patient’s diagnosis and treatment. The provider’s need to meet his or her patient quotas for the day has impacted this interaction, data gathering, and relationship building. The provider’s nonverbal communication of asking a question and grabbing the door knob had affected the patient’s perception of the provider. Although it is true that managed care and other factors have altered the time that some providers can routinely spend with patients, an effective exchange of information must occur. Providers need to remember that nonverbal behaviors often communicate more to patients than verbal communication. So, providers have to be aware of the important role that listening and feedback play in obtaining the information needed to evaluate the patient’s condition.
The biomedical model is designed to assure data gathering related to the signs and symptoms of disease, this specificity requires an emphasis on getting answers to certain key questions and risks missing important information that could have been obtained by listening for more than just the biomedical information. Listening for psychological and/or sociological issues that might be affecting the patient’s condition can provide added information that may be very important to the diagnosis. The provider quickly assesses the patient, gives a brief description of what he or she has determined the cause of the problem to be, and how it will be treated. Although it is clearly a truism that providers need to collect information from patients in order to make an accurate diagnosis and treatment plan, it is just as true that the data can be gathered in an authoritarian, aloof manner or in a collaborative, caring relationship-focused approach.
Teaching students a clinical skill provides faculty an opportunity to also demonstrate/mentor effective communication skills. Health care providers need to communicate with their patients. But interpersonal communication requires trust and sharing of information. It takes little or no extra time to effectively communicate with a patient. However, the rewards for both the provider and patient in terms of information exchange, relationship building, and decision making are critically important to successful outcomes. Communication is continuous, so no matter what type of interaction health care providers have with patients there is the potential to positively or negatively impact other current and future provider-patient interactions. So trying to enhance interpersonal communication behaviors and interpersonal relationships, even during a brief encounter like a blood draw, can have positive ramifications for future health communication.
This chapter presents two interactions between the provider and the patient. The setting, waiting room/receptionist’s office, impact the communication in this scenario. The provider’s loss of autonomy in ordering treatments potentially affect his or her communication. The gender communication of both the provider and the patient impact the conversation. The patient’s efforts at self-education and empowerment affect the outcome of the scenario. The patient’s self-disclosure about the internet searches alters the outcome between the first and the alternative scenarios. Communication often gets distorted by emotional situations and health communication is almost always impacted by emotions. With the increase in insurance company preapprovals for nonemergency diagnostic tests like MRI, communication between the provider and patient or the provider’s office and the patient about expectations is critical. The masculine-gendered communication of the patient leads to a masculine-gendered response by the provider.