Improving communication may influence outcomes, patient satisfaction



LAS VEGAS – Patients recall only about 10% of the information imparted by physicians during an office visit, and about half of all patients don’t understand their treatment plan, according to Richard Nordstrom.

Furthermore, 90% of patients have difficulty following routine medical advice, said Mr. Nordstrom, chief executive officer for a health care communications consulting firm in Montclair, N.J.

The problem isn’t just one of low health care literacy. Patients who receive a significant, life-altering diagnosis often don’t hear much else after they hear words like, "you have rheumatoid arthritis," he said at Perspectives in Rheumatic Diseases 2013.

This is true regardless of a patient’s literacy level, and even those with high literacy may be too embarrassed to ask questions that they think might make them sound uninformed, he noted.

These factors lead to poor outcomes and less patient satisfaction. Improved communication can go a long way toward improving both, he said.

Physicians have so little time with patients; about half of those in a recent survey said that they see between 50 and 100 patients each week. The average time a health care professional spends educating a patient on conditions and treatments critical for the patient’s care is only 11 minutes, and during that time, patients ask an average of only two questions.

"Your moments with that patient are critical," Mr. Nordstrom said, stressing that for the patient, that time is the most valuable time they will spend "in their entire health care ecosystem."

Excellent communication in those brief moments will ensure that the most is made of that time, and that the patient experience is exceptional. Several steps can be taken to improve communication and to enhance the doctor-patient relationship – and to improve satisfaction and outcomes.

For one thing, talk more slowly, he said.

Eleven minutes is not a lot of time, and while slowing down may seem counterproductive, it will allow more information to sink in.

Also, use plain language. "NSAID" may seem like plain language to you, but for a patient, "anti-inflammatory" will likely make more sense. Remember that what may seem like plain language often is jargon.

"One report suggested that if you spend time on an educational intervention on something as simple as an NSAID, you’ll have a fourfold increase in efficacy in pain relief and reduction of inflammation," he said. "Assuming patients understand what they’re supposed to do is not enough."

Visual tools – pictures and "infographics" – are very helpful for improving communication and information retention among patients, as well.

Physicians often scribble information and drawings on the white examination table paper, then crumple that up and throw it away – and patients often fish that out of the trash can and take it home, he said, in explaining the value of visual learning.

"Infographics provide visual ways to communicate a lot of data," he said.

Technology, such as tablet computers, which are increasingly used in the office setting, can assist with this and can be an excellent communication tool rather than just a research tool and a tool for recording patient data.

Other tips for improving communication include using short- rather than long-form information and creating an empathic environment that makes patients feel comfortable asking questions.

Brief communications are important. Many patients get lost trying to navigate through long-form communications. It is important to filter it down to simple, small bits of information, Mr. Nordstrom said.

In addition to improving outcomes and patient satisfaction, improving communication is likely to reduce your risk of being sued for malpractice. One report suggests that at the core of 75% of malpractice cases are one or more of six factors: an inadequate explanation of the diagnosis, an inadequate explanation of the treatment, a feeling on the part of the patient of being ignored, a failure by the physician to understand the perspective of the patient or family/caregiver, a sense on the part of the patient that his or her views are devalued, and a sense by the patient that he or she was rushed.

Conversely, when communication is used to promote a more patient-centered relationship, which Mr. Nordstrom called an "exceptional patient experience," patients tend to come away feeling more engaged, activated, and empowered, he said at the meeting, which was held by Global Academy for Medical Education. GAME and this news organization are owned by Frontline Medical Communications.

Mr. Nordstrom reported having no relevant financial disclosures.

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