Effective Patient Communication: Background, Benefits + Best Practices

By Shayne Foley, MS, PA-C

 

“Good communication is the bridge between confusion and clarity.”

-Nat Turner

There’s no question that effective communication with our patients is critical to performing our duties as PAs. It is central in building the patient-clinician relationship, and is an important aspect of delivering high-quality healthcare. Often, how you say something is just as important as the information you are trying to convey. Your mastery of basic communication is an integral part of the proverbial “bedside manner,” and interpersonal and communication skills are so important that they are considered part of the vital competencies for the PA profession.

The work demands on PAs and all other healthcare professionals have been high, even prior to the SARS-CoV-2 pandemic. With increasing demands on clinical productivity, this translates to less time with each patient, which can impede effective patient-clinician communication. It’s easy to feel overly inundated when many of us are trying to manage any or all of the following communication streams:

  • Office or inpatient visits
  • Telemedicine
  • Phone Calls
  • Email
  • Patient portal messaging
  • After visit and discharge summaries
  • Result notes

Each one of these communication channels has unique nuances and expectations associated with them. Unfortunately, there is not a “one method fits all” when it comes to working through them, but there are some universal strategies that you can employ to increase how effectively you communicate with your patients.

What is Effective Patient Communication?

According to J.G. Elsea, “To be effective, clinicians must assess appearance, environment, field of experience, language skills, tone of voice, listening abilities, cultural differences and body language. Conscious awareness and continual evaluation of all elements of the communication process can significantly improve diagnostic skills and patient compliance, as well as strengthen the bond between patient and provider.”

According to Fong Ha, et al (2010), the 3 main goals of patient-clinician communication are:

  1. Creating a good interpersonal relationship;
  2. Facilitating exchange of information;
  3. And including patients in decision making.

The medical model has shifted to be more patient-centered and individualized, now involving more information-sharing. Emphasis has been placed on open communication and fostering more of a partnership during interactions – for example, the concept of shared decision making.  This paradigm represents a significant shift from the previously accepted paternalistic, “clinician knows best” framework2.4.

Benefits of Effective Communication

There is a wide-ranging spectrum of benefits linked to effective communication with our patients. These include:

  • Decreased risk of patient complaints, including those resulting in litigation
  • Improved patient satisfaction, including perception of a clinician’s competency
  • Improved patient compliance and adherence
  • Improved ability of clinicians to obtain medical histories, leading to the formulation of more accurate assessments and treatment plans
  • Improved emotional health, physiologic measures (i.e., blood pressure and glucose level) and pain control of patients
  • Decreased time spent on follow-up calls and conversations
  • Greater job satisfaction, less work-related stress, and reduced burnout for clinicians

After reading the list above, you should understand how effective communication is paramount to positive healthcare outcomes, on both sides of the patient-provider dynamic. Even more important than the why is the how, so let’s explore some best practices and common pitfalls.

Strategies for Effective Communication

PAs are not inherently born with excellent communication skills, but instead learn effective strategies through our experiences and training. Although skillful communication may be more innate in some, we all need to learn, relearn, and constantly hone this aspect of the art of practicing medicine. The most effective communicators employ most, if not all, of these best practices:

  1. Use of collaborative communication
  2. Minimizing of medical jargon and other confusing language
  3. Use of empathetic verbal responses and non-verbal cues
  4. Personalization of the exchange to meet the patient where they are
  5. Use of open-ended questions
  6. Allowance of adequate time for patients to speak
  7. Recognition of the influence of your potential biases and minimizing their impact
  8. Application of widely-accepted strategies such as teach-back, active listening and use of affirming responses
  9. Uncover the patient’s biggest concern and directly addressing it
  10. Acceptance that we are all lifelong learners of communication skills
Common Communication Mistakes

In addition to the best practices recommended above, here are some of the most common pitfalls during patient-provider exchanges:

  1. Not introducing yourself
  2. Poor eye contact (i.e., staring at the computer)
  3. Not sitting down during an encounter
  4. Speaking and moving rapidly
  5. Closed body language (e.g., crossed arms and/or legs)
  6. Constantly interrupting the patient or caregivers

With clinical demands and constraints as high as they are, it often feels challenging to not only complete the tasks that we face, but to also do so effectively. Communicating with our patients is one area where we cannot afford to be ineffective, given what we know about the consequences for both patients and providers. Therefore, being steadfast in our implementation of effective communication strategies, while avoiding the common pitfalls, is the cornerstone of the patient-provider dyad.

References:
  1. http://www.ochsnerjournal.org/content/ochjnl/10/1/38.full.pdf
  2. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2014/02/effective-patient-physician-communication
  3. https://journals.lww.com/jaapa/pages/competencies.aspx
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3771166/
  5. https://pubmed.ncbi.nlm.nih.gov/10314675/

 

Shayne Foley is a certified and full-time PA with 10 years of practice under his belt. Shayne has worked in internal medicine, urgent care and currently family medicine.  He is involved in PA education as an adjunct faculty member, preceptor and mentor.  In an effort to expand his impact on the profession, he co founded The PA Blueprint, LLC, whose mission is to provide career education to current and future PAs.  They have worked with 30 PA programs around the country, and their work has been featured on AAPA’s Career Central, as well as multiple PA-related podcasts and blogs.  Shayne has established himself as an important contributor to the PA profession through his teaching, writing, and online presence, and is passionate about moving the profession forward.

Thank you for your interest!

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