The Coast News Group
Scripps Health Watch

Keys to great patient-doctor communication

The patient-physician relationship should be based largely on trust and confidence in the doctor’s medical expertise. But clear communication between the two parties also plays a critically important role in making the delivery of health care as effective as possible.In situations where the physician’s method of communicating is inconsistent what the patient prefers, the patient may feel frustrated, confused or even ignored. For example, patients who expect their doctor to personally call them to discuss test results may be upset when the results arrive by mail. A patient who has questions may want to speak directly to the physician, but the nurse or assistant may return phone calls instead.

Oftentimes, patients may be able to prevent such potential conflicts with physicians by openly discussing their expectations and asking key questions. How does the physician handle routine and urgent questions? How long will it take to have someone call back? Does the physician communicate by e-mail? How and when will test results be delivered? If the patient isn’t satisfied with how communications with the physician are structured, a different doctor might be a better match.

A physician’s approach to delivering care also may affect the dynamics of patient-doctor communication. While most primary care physicians have similar training and education, their practice styles can differ greatly. Generally, most physicians fall into one of the following three types:

Negotiators. These physicians tend to offer patients several options, and recommend the one they think is best. “You can take this medication or try to lower your cholesterol with diet. I recommend the medication.” Many patients prefer having alternatives, but want to know why the doctor feels a certain choice is best.

Egalitarian. These doctors typically offer several options, and leave the final decision up to the patient. “You can take medication or try changing your diet. What would you like to do?” Many younger people tend to prefer these physicians; they like to research their conditions and be involved in their own health care decisions.

Paternalistic. These physicians tell patients exactly what they need to do; for example, “You should take this medication for your high cholesterol.” Many patients appreciate this authoritative approach. They believe the doctor is the expert and knows best, and they don’t want to research alternatives on the Internet or discuss options.

It is clear that a patient who prefers an egalitarian approach would probably be uncomfortable with a paternalistic physician, and vice versa. Since physicians aren’t likely to change their approach communicating with patients, it may be best for patients to find someone whose interpersonal style is a good match with theirs. Start by identifying the preferred approach and communication style. If it matters that the physician is male or female, or younger or older, add that to the list.

When meeting with a potential provider, discuss expectations and ask questions. The more open the lines of communication are from the start, the stronger the patient-physician relationship is likely to be.