Communication Strategies to Help Physicians Lead Meaningful Patient Conversations

Photo by Steve Fisch.

Leading patient conversations is an important clinical skill that helps physicians build relationships while learning more about the patient’s physical condition and, more broadly, their lives. Without these discussions, physicians may miss valuable opportunities to develop connection while treating the whole person (instead of just their symptoms).

Let’s take a closer look at how physicians can transition into substantive discussions through simple yet effective communication strategies that encourage conversation, transparency and partnership.

Employ Best Practices for Physician-Patient Communication

According to the National Academy of Medicine, as medicine becomes more personalized and more complex, it’s more important than ever for physicians to master patient communication.

To further promote interactions between patient and physician, NAM recommends the following principles:

1.    Develop mutual respect that recognizes both clinician and patient as full decision-making partners.

2.    Create harmonized goals that include a common understanding and agreement on a care plan.

3.    Promote a supportive, secure environment that encourages individuals to speak openly.

4.    Involve appropriate decision partners, such as other clinicians or care teams that can provide alternative opinions or supportive care.

5.    Provide correct, evidence-based information to aid in decision-making.

6.    Be transparent and fully disclose all limitations so that decisions can be made with complete understanding.

7.    Develop an approach to communication that allows for feedback from both parties to guide continuous learning.

Use Follow-Up Questions to Invite Conversation

During these interactions, remember that encouraging patients and their loved ones to open up doesn’t have to be complicated. For example, simply asking “what else” can be effective, according to Texas Children’s Hospital’s Matthew McEvoy, MD.

In a CLOSLER article, McEvoy recounts a memorable experience with the father of a seriously ill child. The father was angry and expressed frustration with the care team. In response to his complaints, McEvoy’s attending physician asked, “What else?” urging the father to share more of his feelings.

McEvoy describes what he observed in that moment: “Silently, I marveled at the healing power of my attending’s two-word communication tool, seemingly simple but profoundly effective when delivered with insight and care.” With that simple phrase, McEvoy adds, the attending physician addressed the father’s needs and concerns while offering validation.

As McEvoy’s anecdote illustrates, asking the right questions is important, but listening to responses is equally valuable. According to research, says McEvoy, clinicians interrupt their patients early and often. “How often do we truly listen well?” he wonders. “We barge to the bedside, ready to rattle off our routine questions and pronounce our premeditated plan. Do we pause between comments? Does our body language communicate openness? Do we elicit our patients’ concerns and adapt the conversations to address them? Or does our list of topics supersede theirs?” he writes.

Ultimately, creating space for patients to share their thoughts and feelings can, in itself, promote healing. As Stanford Medicine 25 continues to study the nuances of patient communication, we encourage you to visit our previous blog posts on how robust communication skills are critical for strengthening the physician-patient relationship—a cornerstone of bedside medicine.

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