Thomas L. Schwenk, MD
reviewing Zulman DM et al. JAMA 2020 Jan 7
Healthcare experts evaluated physician–patient interactions and recommended five practices.
Productivity demands and administrative tasks, particularly those associated with electronic medical records, often are blamed for detracting from the quality of physician–patient interactions and thereby lowering patients’ satisfaction with their healthcare. Stanford investigators attempted to identify specific physician behaviors that enhance physician presence and patient experience.
The authors conducted a systematic literature review, observed interactions between patients and physicians known to have excellent interpersonal skills, and interviewed a diverse group of physicians, patients, and nonmedical public service professionals. Drawing from these sources of information, 14 healthcare experts and patient advocates eventually developed a set of five practices that could enhance patient–physician interactions:
- Prepare with intention (focus on specific patient needs, agendas, and potential outcomes before each patient encounter).
- Listen intently and completely, using nonverbal behaviors such as an open body position and leaning forward.
- Agree on what matters most (incorporate patient priorities into visit agenda by using consensus-building interview techniques).
- Connect with each patient’s story by exploring and affirming family and psychosocial factors.
- Explore emotional cues (pay attention to verbal and nonverbal cues and ask follow-up questions).
Comment
The details of each recommended practice are worth exploring. Similar practices are taught regularly during medical training and likely will look familiar to most physicians. However, such behaviors frequently are lost in the stressful and often chaotic healthcare environment. These practices are proposed to enhance physician and patient satisfaction and to improve healthcare outcomes. Although we believe intuitively that they might accomplish these goals, none of these hypotheses has been tested quantitatively.
Zulman DM et al. Practices to foster physician presence and connection with patients in the clinical encounter. JAMA 2020 Jan 7; 323:70. (https://doi.org/10.1001/jama.2019.19003)