The Case for Compassionate Communication – KevinMD.com2
Originally posted on kevinmd.com
A majority of physicians see between 11 and 20 patients per day, and among all practices, the majority of doctors spend between 17 and 24 minutes with each patient. Assuming a five-day workweek, this translates to more than 900 patient interactions per year and over 1,066 minutes spent communicating with patients. Today, many of these interactions fall short of effective communication so pivotal to building rapport, trust, and loyalty with patients and ultimately driving down the bottom-line results.
While most physicians are compassionate by nature, many struggle to convey that compassion. A recent survey on doctor-patient interactions found that 71% of patients reported they’ve experienced a lack of compassion when speaking with a medical professional, and 73% stated that they always or often feel rushed by their doctor. These findings highlight the need for medical professionals to develop the “soft skills” – verbal and non-verbal communication techniques, listening skills, and empathy – critical for transforming the patient experience, increasing patient satisfaction, and improving outcomes.
In an era of online reviews and government surveys such as HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems), patient satisfaction becomes a key driver of bottom-line results for health care providers. According to a 2018 Deloitte report, hospitals with excellent HCAHPS scores had a net margin of 4.7% on average, as compared to a net margin of just 1.8% for hospitals with low ratings.
The Beryl Institute, an organization dedicated to improving the patient experience found that 91% of consumers considered patient experience extremely or very important to them and significant to their future health care decisions., Press Ganey, one of the largest administrators of patient satisfaction surveys, found that providing a good patient experience is five times more likely to influence brand loyalty than other marketing strategies.
Improved patient satisfaction also leads to improved compliance with the prescribed treatment plan, better patient outcomes, reduced malpractice claims, and even a reduction in physician burnout.
Effective and compassionate physician communication is often a casualty of stretched-too-thin medical professionals who are becoming more task-oriented rather than patient-oriented. There is a misalignment between this task-oriented approach and a patient’s desire for a trusting relationship with their health care provider, along with a demand for more from their physician than simply being a good clinician. Patients seek relatable physicians and nurses who care about them as if they were part of their extended family.
Medical professionals can better align with today’s patients by understanding the importance of communication, rewiring their communication skills, and learning new techniques that will build rapport and trust with their patients. By learning to communicate better, physicians can provide a good patient experience and remain efficient with their time.
Patient communication isn’t just about asking the right questions. Verbal and nonverbal cues, as well as tone and cadence of voice are communication nuances that are equally as important. Training that focuses on specific communication techniques can help physicians learn compassionate communication techniques that foster a better connection with their patients without compromising efficiency.
The questions below capture some tried, and true techniques physicians can use to increase rapport and trust with patients.
Are you sitting down?
Clinicians and nurses should make it a practice to sit down as soon as possible after entering a patient’s room. Physicians entering a patient’s room and speaking while standing sends a nonverbal message that they are rushed and don’t have sufficient time to spend with the patient. The simple act of sitting down can go a long way toward building rapport and making patients feel comfortable. In fact, studies have shown that physicians who sat down during a patient interaction were perceived as spending more time with their patient than those who spent more time standing.
Can you hear me now?
Active listening is defined as the ability to fully concentrate on a speaker, understanding what is being said and thoughtfully responding. This is a skill that is learned and developed with practice. When a patient perceives a physician is actively listening, they feel more comfortable communicating with them. Active listening also means avoiding the temptation to interrupt – something physicians struggle with.
Researchers at the University of Florida and the Mayo Clinic recorded 112 clinical encounters and analyzed how effectively doctors listened to patient concerns. The study found clinicians elicited the patient’s agenda in just 36% of encounters, and in 67% of the encounters in which clinicians elicited patient concerns, the clinician interrupted the patient after a median of just 11 seconds.
Although physicians are taught to take a detailed medical history and ask the right questions in an interview-style conversation, interrupting patients while they are answering provides little opportunity for the patient to fully express their concerns.
Physicians will build better rapport with patients by asking open-ended questions, avoiding the temptation to interrupt, and actively listening to what patients are saying and how they are saying it.
Where is your focus?
Physicians often focus on entering information into electronic health records (EHR) while the patient is talking. This has the net effect of giving the patient the impression the doctor is not listening and makes it more difficult for the patient to form a bond with that physician. By interacting with technology instead of actively engaging with the patient, physicians miss communication nuances, such as the patient’s facial expression or tone. A lot of information can be gathered by simply observing a patient while they’re speaking. Some hospitals and practices address this issue by having scribes in the room to enter information into the EHR. This allows physicians to give their undivided attention to the patient. This practice, however, has not yet been widely adopted.
Are you a model train enthusiast too?
A great technique for building a connection with patients is to find an area of commonality with them. Engage in some general conversation to find something in common with a patient such as rooting for the same sports team, enjoying the same hobby, or having children around the same age. This technique can open the lines of communication with that patient and increase their comfort level. It also helps patients relate to their doctor and fosters the trust critical to establishing a relationship.
Communication is the number one factor influencing the patient experience. Health care professionals that learn new techniques for communicating compassionately and building trust and rapport with patients can dramatically enhance patient satisfaction and improve outcomes.
Anthony Orsini is neonatologist and founder, The Orsini Way. He is the author of It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation.
The economic fallout of the global pandemic has resulted in an influx of layoffs and furloughs, leading to many difficult conversations between employers, employees, staffing agencies and candidates. Delivering tough news in a professional setting is never easy, but it’s especially challenging when the discussion involves separating an employee from a company.
In many ways, difficult dialogues in business run parallel to difficult dialogues in medicine. From my time as a neonatologist, I’ve taken the lessons I’ve learned from breaking bad news to patients and their loved ones and applied them to the workplace. Communication training is now more important than ever, as many business leaders may feel under prepared to handle pandemic-fueled uncomfortable situations.
In fact, data published in consulting firm DDI’s Frontline Leader Project found that frontline managers rate difficult conversations as one of their top challenges, even prior to the Covid-19’s emergence.
In medicine and in business, strong communication skills are, by and large, not inherent. Compassionate communication is a learned skill that takes practice and preparation. The following tips can help you more easily navigate these difficult conversations and ensure all staffing professionals and HR leaders are communicating with empathy and compassion.
Develop a plan. Have a detailed, well-thought-out plan before starting the conversation.This involves not just thinking through how to deliver the news but also anticipating the reaction and preparing to adjust. Planning for an uncomfortable conversation should include a healthy dose of imagination: think of how you would react to this news yourself, and make necessary changes based on empathy. Knowing what needs to be accomplished in the conversation and how to get there can help diffuse some of the anxiety around delivering bad news.
Choose your words carefully. Words matter; it’s important to choose every word carefully. Think beyond just definition and focus on connotation, as each word may evoke a unique feeling to the person receiving it. This is further amplified when emotions are running high. Even in situations with a lot of uncertainty, such as the Covid-19 crisis, using phrases such as “I am concerned” instead of “I think” shows compassion and empathy even in unpredictable circumstances.
Don’t rush. Avoid the temptation to rush through the delivery of bad news. You don’t have to draw the conversation out, but take a moment to add context and important background information before immediately delivering tough news. This will prevent the employee from feeling blindsided.
You must also consider the tone, cadence and inflection of the words spoken to avoid seeming insensitive or rude. A rapid cadence, for example, is often interpreted by the listener as rushed and anxious. Proper use of pauses at critical times can transmit feelings of compassion and sensitivity toward the situation.
Don’t forget non-verbal language. Research by UCLA psychology professor Albert Mehrabian found that 7% of messages are derived from words, 38% from tone, and 55% from body language. When an employee is called into a conversation, one of the first things they will do is analyze the manager’s body language to determine if this will be good news or bad news.
There are several nonverbal ways to show compassion. For example, make sure everyone is seated comfortably before any serious conversation takes place. This sends the nonverbal message that you understand the gravity of the situation and are not waiting with one foot out the door. Embracing the silence, while difficult to do, is also an important nonverbal cue for sending the emotional message that you are listening and comfortable.
Actively listen. Active listening is defined as the ability to fully concentrate on a speaker, understanding what is being said and thoughtfully responding. This is a skill that is learned and developed with practice and key to delivering difficult news with compassion.
You can add more compassion to these difficult conversations by giving employees time to respond and ask questions. Actively listening to their feedback and thoughtfully responding to their questions demonstrates a respect and concern for their perspective.
It’s never easy to deliver bad news, but honing communication skills with training can help staffing and HR leaders handle these situations more effectively and communicate more compassionately.
Dr. Anthony Orsini is a practicing neonatologist and founder of The Orsini Way, a training program that shows healthcare professionals a way to communicate that enhances patient satisfaction and improves outcomes. He is also the author of “It’s All In The Delivery: Improving Healthcare Starting With A Single Conversation” and recently launched his podcast: Difficult Conversations – Lessons I Learned an ICU Physician.