Patient–doctor communication

摘要: Communication is an important component of patient care. Traditionally, communication in medical school curricula was incorporated informally as part rounds and faculty feedback, but without a specific or intense focus on skills communicating per se. The reliability consistency this teaching method left gaps, which are currently getting increased attention from schools accreditation organizations. There also interest researching patient-doctor recognizing the need to teach measure clinical skill. In 1999, Accreditation Council for Graduate Medical Education implemented requirement residency programs that focuses "interpersonal communications result effective information exchange teaming with patients, their families, other health professionals." National Board Examiners, Federation State Boards. Educational Commission Foreign Graduates have proposed examination between the. third fourth year "requires students demonstrate they can gather perform physical examination, communicate findings patients colleagues" using standardized patients. One's efficiency effectiveness be improved through training, it unlikely any future advances will negate value compassionate empathetic two-way clinician patient. published literature expresses belief essential role communication. "It has long been recognized difficulties delivery care arise problems provider rather than failing technical aspects Improvements provider-patient beneficial effects outcomes". A systematic review randomized trials analytic studies physician-patient confirmed positive influence quality outcomes. Continuing research arena important. For successful humanistic encounter at office visit, one needs sure patient's key concerns directly specifically solicited addressed. To effective, must gain understanding perspective his her illness. Patient wide ranging, including fear death, mutilation, disability; ominous attribution pain symptoms; distrust profession; concern about loss wholeness, role, status, independence; denial reality problems; grief; leaving home; uniquely personal issues. values, cultures, preferences explored. Gender another element taken into consideration. Ensuring issues verbalized openly fundamental should careful not judgmental scolding because may rapidly close down Sometimes gains therapeutic benefit just venting safe environment caring clinician. Appropriate reassurance pragmatic suggestions help problem solving setting up structured plan action required. Counseling around unhealthy risky behaviors skill visits. Understanding psychology behavioral change establishing framework such interventions, includes five As counseling (assess, advise, agree, assist, arrange) steps toward ensuring Historically medicine, there paternalistic approach deciding what done patient: physician knew best accepted recommendation question. This era ending, being replaced consumerism movement shared decision-making. Patients advising each "educate yourself ask questions". satisfaction care, rests heavily how successfully transition accomplished. Ready access thoughtful discussions fulcrum revolution.