Featured Guest Contributor
The Bond Between Us: Improving Communication with Our Patients and their Families
By: Jonathan S Berek, MD, MMS
Jonathan S Berek, MD, MMS, directs the Stanford Health Care Communication and Advanced MD-C-I-CARE Program.
Have you encountered situations with patients and their families that have been emotionally difficult or awkward? Do you find yourself sometimes uncertain what to say during interactions with patients? Have you reflected on a conversation with a patient and wished you had handled it differently?
Most medical staff personnel feel confident about their education, skill and ability to provide superb patient care. They do not dwell on concerns about their interactions with patients and patients' families or other professional staff. Nevertheless, it is not unusual to encounter challenges with complicated situations involving patient care, difficult diagnoses or treatment regimens that require finesse, compassion and thoughtful communication.
It is incumbent upon us to develop and enhance the empathy and awareness that are essential for correctly assessing and responding to complex human situations. Research indicates that health care outcomes and physician wellness are influenced by the quality of communication in the patient care environment. For patients, effective communication has an impact on physiological outcome, information exchange, decision-making, compliance, symptom relief and satisfaction with care. For physicians, improved communication skills can increase professionalism and personal fulfillment, while decreasing frustration, burnout and malpractice claims.
Advanced MD C-I-CARE is part of the Stanford Health Care Communication Program and is designed to improve communication between doctors, patients, families and the health care team. The goal is to improve health care by developing our abilities to listen to patients, to converse with them and their representatives and to ensure that we make the empathetic connection that is fundamental to the therapeutic relationship. Personalized individual care is most effectively delivered by those physicians who are able to connect compassionately with their patients, respond appropriately to a broad range of emotions and conduct the difficult conversations that are part of our health care mission.
Enhancing the therapeutic relationship with our patients is our goal. Listening carefully and respectfully to them encourages open expression of their concerns and emotions, which facilitates our understanding of their message. We are better able to hear what they are telling us and better prepared to explain what we need them to understand – thereby improving patient care.
This Advanced MD C-I-CARE program will be presented in a workshop format led by faculty facilitators with special expertise in communication. It encompasses video demonstrations, discussion, and role-play based upon key elements of communication. Module themes include building trust and empathy, handling difficult conversations such as breaking bad news, and dealing with emotions. The program's goal is to engage physicians in a dialogue about difficult communication experiences and to impart new techniques that can be used to augment their established health care skills.
Although other academic medical centers have communication programs – such as those at the Cleveland Clinic and MD Anderson – the Stanford program is unique. A multidisciplinary team of Stanford physicians was involved in its development and the program's design will be piloted across several specialties in order to benefit from multi-viewpoint feedback. This interactive process will yield a flexible tool that will provide useful assistance for the daily challenges of the health care environment. This fall the program will debut a film concerning the nature and importance of communication from the perspective of the patient and the physician.
A patient's journey through our health care system can be challenging. Each patient carries an array of life experiences and cultural expectations that may be vastly different from those of the health care providers they encounter. Life changing interactions between patients and physicians begin as choreographed, yet intimate, exchanges between strangers. Often there is a layer of emotional unease that accompanies a patient's physical discomfort, which affects their reactions to an unfamiliar environment. Respect, courtesy and patience can facilitate understanding, trust, patient outcomes and physician wellbeing.
If you are interested in having a workshop in your program, we are accepting applications for next year through July 31, 2015. Please contact Merisa Kline at mkline@stanfordhealthcare.org with a brief description of your specialty area and goals for participation.
Jonathan S. Berek, MD, MMS, is the Laurie Kraus Lacob Professor of Obstetrics & Gynecology–Gynecologic Oncology; Director, Stanford Health Care Communication and Advanced MD-C-I-CARE Program; Chair of the Department of Obstetrics and Gynecology and Director of the Stanford Women's Cancer Center.