I believe one of the communication gaps in physician-patient interactions is a result of physicians focusing on the disease, rather than the patient with the disease. It is no surprise that the same disease can affect patients across the spectrum very differently, and understanding how the problem affects each individual patient’s life is essential to successful treatment.
As discussed in Stephen Wilkin’s “5 Clinician-Patient Communication Gaps,” by failing to understand the context of the patient’s life, one misses the patient’s fears and concerns, relevant experiences and expectations, their hopes, and beliefs and attitudes.5 Relevant experiences and expectations are important in that they influence how patients perceive and receive medical information, which can subsequently impact adherence to treatment. Our understanding of the individual differences and unique behaviors of patients should help us tailor education towards their differences and optimize an individual’s ability to comprehend the information given to them. This may include involving learners in diagnosing their learning needs, designing and carrying out learning plans, and in evaluating their learning outcomes. This coincides with a proposed best practice approach for communication in medical encounters, which encourages physicians to listen actively and elicit the patient’s perspective on the problem at hand when gathering information.
In order to act on the principles of building on life experiences and intrinsic motivation, we must spend more time talking to our patients to understand what their motivations are in bettering their health, what preconceived notions they may have, and thorough education on what could happen if compliance is not enforced. These variables vary from person to person and are vital to identify so that we can best tailor education to the individual patient – there is no one size fits all when it comes to educating patients. The importance of physician-patient communication is demonstrated in the association of good physician communication with patient’s satisfaction with care, health outcomes, and adherence to treatment (Zolnierek 2009). By communicating in a way that is sensitive to the patient’s individual needs and emotions, the physician can better tailor treatment and likely improve treatment compliance. I vow to always consider the patient as a whole and take a holistic approach to treatment by considering the patient’s unique circumstances and preferences. It is crucial that we as physicians treat the patient with the disease, and not merely the disease itself.
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Wilkins, S. “5 Clinician-Patient Communication Gaps Compromising Your Hospital’s Outcomes and Perspectives.” June 2013.
Zolnierek KB & DiMatteo MR. Physician communication and patient adherence to treatment: a meta-analysis. Med Care. 2009;47(8):826-834.