 |
| Symbol Table for Non Verbal communication with patients (Photo credit: Wikipedia) |
 |
| A patient having his blood pressure taken by a physician. (Photo credit: Wikipedia) |
Medical Assistants in most practices either spend more time
with patient or a least a comparable amount of time as the physician or nurse practioner.
It is essential that the medical assistant have effective communication skills
and avoid roadblocks to communication. This can be called developing
therapeutic communication skill.
This applies to medical assistants throughout the practice.
Front desk and billing medical assistants also have significant amounts of
communication with patients. The attitude of the whole staff will affect the patient’s
attitude towards the practice and treatment compliance.
Sometimes when patients make appointments the medical
assistant who schedules the appointment must play detective. Is the patient
really calling to be seen for what they say? Is the patient calling to discuss
a matter that is an ongoing medical concern that could be addressed by a phone
call? Is the patient experiencing a medical event that requires a same day
appointment? Is a care giver calling for advice and is not sure if they need to
bring the patient in? This an the recent changes in managing prescriptions
electronically and in healthcare will leave the simple task of scheduling appointments
into one where you will have to have very good communication skills in order to
service the patient’s need’s and direct their call appropriately.
Those who work in billing are also going to be bombarded
with insurance questions related to the Affordable Care Act. You will be
getting patients who are not sure what preventative services is cover or who
have never had insurance before and do not understand concepts like what a
co-pay or deductible is.
You may have had additional training to deal with the
patients, but you must learn how to communicate complex insurance ideas to the
patient. Especially, patients who do not understand their bill under this new
system, might have a think their billing is being mis-managed.
What is Therapeutic Communication?
Therapeutic communication is that which expresses empathy
for the patient. It is best when discussing events that may be traumatic to the
patient, but should be used in the course of communication with the patient as
it falls in to the area of best practice.
Therapeutic communication is that which puts the patient at
ease and elicits the answers needed to provide the best patient care. It is not
medical lingo. It is translation the diagnosis, treatment protocol, and prognosis
into language the patient can understand. It is a way of managing the interview
and educational discussions with the patient that lowers their stress level. An
increased stress level in a patient can cause them to use self defense
mechanism that block clear communication and make your job as an effective
medical assistant much harder.
Things to be aware of when seeking to use Therapeutic
Communication with a Patient
We all have personal bias and prejudices that may influence
how we interact with a patient. If we believe that an older patient suffers
from dementia we may disregard their expressions of concern of discomfort. We
may believe that a patient with a questionable immigration status can not
access the practices system of care. These are not your issues. You must first
and always address patients personally and with concern. Ask and record the
elderly patient’s responses to the best of your ability.
Address them with the
same respect regardless of the appropriateness of the response. Then address
their care giver for clarification. This approach takes more time but it is the
best way to establish the most productive relationship with the patient. In
regard to a patient’s ability to pay, only inquire about such issues if the
patient asks about financial arrangements. Then refer them to the appropriate
source. Medical assistants who work in billing will have much better chance of
explaining all the options with the patient. if they have not left the exam
room feeling insulted by your inquiries about their insurance coverage status.
These are just two examples. To avoid your personal produces
and bias, simply apply the golden rule and put forth a positive attitude. This
does not mean to be Pollyanna, but to be pleasant and straightforward and to be
committed to treat every patient with the attention and respect they deserve.
Patients come with their own set of bias and prejudices.
Part of therapeutic communication is to not personalize the patients expression
of these beliefs. Again many older patients may not have had the experience of
cultural diversity that younger patients may have had. If they seem to be
uncomfortable with your race, ethinic background or sex. As a professional
medical assistant you must simply have
to over look it. Medical assistants are not the moral police. If a male elderly
patient is uncomfortable with a male medical assistant or visa versa then politely agree get one in the exam room.
You may have to ask the patient to wait longer or
reschedule, and if anger on their part erupts, use the skills you have to diffuse
the situation. Apologizing for the incontinence and giving alternatives goes a
long way. Also make sure you politely restate the patient’s request. Do not
reprimand or insult a patient for expressing negative stereotypes, simply hand
the situation and make notes about the patient’s preferences without comment on
your opinion. Difficult people need access to medical care too and their
positive interaction with you may diffuse some of their fear of cultural
diversity
The basics of therapeutic communication
This hub can only cover the generalities of therapeutic
communication. First you must be able to successfully evaluate the patient’s
mood. In the case of a routine exam with a patient that has been to the
practice the patient is probably pretty emotionally neutral or pleasant if they
have a positive relationship with the practice. They will have positive facial expressions
and open body language. Open body languets means that they will be relaxed and
their arms will not be crosses. In general they will appear open and not under
stress. They will engage in pleasantries and chit chat. These of course are the
patient’s that we find easiest to deal with. It is easy to reflect the
patient’s mood back to them. There is congruency in the communication because
the patient knows what to expect and is not expecting any surprises.
In this type of patient interaction it is best to keep the pleasantries
to a minimum to keep the patient focused at the task at hand. If the patient
seems to be in somewhat of a hurry or anxious about the length of a check up ,
it is best to restate and inquire about that concern and give them a realistic
time frame , remind the patient that the doctor might end up taking longer
because he or she is giving everyone the best attention possible.
You also will have to update patient information in a way
that may require that you ask questions that the patient feels they have
already answered. Again, simply state this is part of the task and empathizes
with them having to repeat so much information.
If something serious is found in check up, it is important
that you reflect hat you understand the patient’s concern. Again be congruent
in your Reponses. If the doctor is sending the patient for more tests be sure
to reassure the patient that the doctor is doing what is routine in the case of
an unseal finds in the routine exam. Be sure to give the patient all the
information they need including the way and the time it will take them to get
the test results. Showing genuine concern and empathy for what may be an
unexpected serious medical concern with influence the ongoing treatment of this
patient. This is what therapeutic communication tries to achieve the best
patient comfort level possible under the circumstances that will assure the
best patient compliance with testing and treatment
Patients new to the practice will have varying degrees of
anxiety. First impressions count so put your best communication skills forward.
Make it therapeutic communication from the moment you meet new patients. Empathize
with starting with a new doctor. Be honest about the length of appointments. If
you work the front area make sure you give the practice policies other than
just the privacy notice. Ask if the patient has questions or concerns about
being a new patient. If the patient is having difficulties getting records transferred
make the extra effort and offer to fax needed forms for them. The practice can
not serve the new patient’s needs without a complete medical history.
If patients have filled out long patient histories in the
waiting room, tell them in advance they may have to clarify questions they have
already answered.. Use your most effective summary skills and restatements to
get the information you need in the least amount of time. Inquire again in the
exam room about any concerns or resources the patient might need to know when
becoming a new part of your practice. Getting off on the right foot will help
you have a productive and pleasant relationship with the new patient for years
to come.
If you work with specials populations like the elderly or children
then you will need to have additional skills in order to engage in therapeutic
communication. In general you show respect for elderly patients with the
understanding that reduced vision, hearing, or cognitive issues may require you
exercise more patience. A medical assistant can not get frustrated when questions are not
understood by an elderly patient.
It helps to have some basic knowledge of child development
to speak effectively with children. Questions and statements should always be
directed toward the child first and the care giver secondly as much as possible.
Obviously, with very small children you must be able to surmise non verbal
communication of the child in addition to what their care giver is telling you.
Special practices such as oncology and hospice require knowledge
of therapeutic communication with in the context of crisis and grief. Today
cancer is not a death sentence for most but a struggle that puts huge financial,
emotional, and physical stress on the patient and all of their family. The
ability to empathize and be a support for the patient first and secondarily to
the care givers is important. The length of cancer treatment means you will be
dealing with the patients on a regular basis for an extended period of time.
Therapeutic communication that encourages absolute adherence to treatment protocols
is essential. This is especially true if for the patient the illness seems less
painful than the treatment. Understanding that patients will become
uncooperative and depressed during the course of therapy is essential, giving
moral support and showing that you understand can help resolve issues of
noncompliance.
Patients who face end of life issues and their family need
specialized forms of therapeutic communication that may require you to study
skills outside the context of normal medical assisting communication.
In the end therapeutic
communication with patients
becomes the normal way you interact with all patients. Dealing with patients in
crisis situations can take a toll on your emotional health and communications
within your personal life. Make sure that your have a support system and a
method to manage your stress as a health care provider.
No comments:
Post a Comment