Communication Skills Ppt @ Bec Doms Mba 1st Sem

8/2/2019 Communication Skills Ppt @ Bec Doms Mba 1st Sem

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Communication skills



Key communication skills

Let parents express in own words

Observe non verbal clues

Encourage the patient to continue speaking

Establish eye contact

Active listening



Verbal communication

• What to say ?

How to say?

Whom to say?

When to say?

What you should not say?



Important points incommunication

• Feel good about yourself

Learn to avoid using ‘I’ and ‘ME’

Instead use ‘YOU’ and ‘WE’

Pause, pace, pitch, and voice modulation



The SOFTEN technique

S = smiling

O = open body posture

F = friendly energy

T = touching while talking

E = eye contact

N = nodding in affirmation



Non verbal communication(body language)

• Eye contact

Facial expressions



Communication pitfalls

• Using highly technical language

Not showing appropriate concern

Not listening

Failing to verify whether understood

Displaying apathy



Telephonic

consultation



Issues related totelephonic consultation

Convenient for parents (too much time and

energy spent to see the doctor – just for few

minutes)

Convenient for doctors (quality time for clinic

patient - improves outcome)

Should be selective and safe

Must develop methods to avoid interference



Telephonic consultation – when?

Minor problem that may not require physical

examination

Follow-up report after initial consultation

First aid advice in an emergency till parents

reach the doctor



Telephonic consultation whennot?

Patient not known (not a regular patient)

Acute illness in neonate or young infant

When condition can not be judged properly

(exaggerated or ambiguous statements by parents /

symptoms potentially serious such as excessive

crying or lethargy / chronic problems)



Telephonic consultationwhen not?

When specific therapy may be

necessary

When parents insist on being seen (even

when you feel otherwise)



Ideal way

Have a trained doctor to attend phones who

follows preformed protocol (even simple

advice needs your Ok / you speak if parentsinsist)

Monitor conversation; intervene if necessary

Insist on talking to a treating doctor if

patient is already under treatment

Legality issues? – ideally need for



Counseling parents of

children who are notimproving



General rule

Counseling is an art

Depends on communication skills

Explain in simple language using similesrelated to common life situations (drug

may not work even when chosencorrectly – pencil does not write if givento newborn)



General rule

Use words cautiously – ABC – accurate /brief / clear

Balanced statement of prognosis

“Patient” hearing and repeated

explanation



Acute serious illness

At first visit, explain details of illness

and its evolution to present seriousstage

Do not find faults with previous therapy(pneumonia who came in with hypoxia)



Acute serious illness

Instill hope and confidence (many such

children improve) with subtle hint (few

may develop problems, let’ s hope we

don’t face it)

Estimate time and course of

improvement – wait for sustained

progress before announcing



Acute illness in office practice

Spend adequate time; explain problem,

anticipated course, and its rational

management

Convince parents about safety of observation

with minimal action (are you sure, is the

question that needs confident answer)



Acute illness in office practice

Be transparent; spell out what you don’t

know but add that you know how to

know!

Document provisional diagnosis and itsbasis with instructions for therapy and

follow-up



Chronic disease

Explain in details (like teaching session)

Describe all the options of investigations and

management ( MR / asthma / JCA / epilepsy)

Discuss pros and cons of treating and not

treating or different modes of therapy

Chart out anticipated course on compliant

therapy, limitations of “cure”and adverse

drug reactions along with monitoring



Chronic disease

Leave the choice of other systems of

medicine to parents and do not criticize (but

emphasize on transparency, access to

unbiased information and evidence based

approach in allopathy)



Managing death

It is said that -

If one looses a parent, past is lost

If one looses a spouse, present is lost

But if one looses a child, future is lost

Hence parents cannot tolerate death of a

child – they need support



In the event of deathanticipated

Ensure that senior doctor is a spokesperson

and not juniors or resident doctors (other

doctors must repeat what senior has talked)

Parents must be subtly warned about non-

improving situation (we are trying our bestbut so far there is no improvement)



In the event of deathanticipated

Confide in 1-2 close relatives about the

inevitable unfavorable outcome

Let parents be a witness to continuous

monitoring and necessary interventions



In the event of death

Do not announce death suddenly (condition is

worsening though we won’t give up / next half

an hour is crucial, if there is no improvementby then, we may not make it)

When death is announced, let parents venttheir feelings (we are sorry we could not save

your child)



In the event of death

Ensure every help to ease the situation

Consider the possibility of subsequent

discussion with parents to make them feel

that everything possible was tried and that

they had not faulted



Summary

Counseling is an art – not taught in medical

school – make an effort to learn

It should not be a casual approach -

especially in serious conditions, ideally

carried out in a specified place with privacy

and not in a hurry

More the serious nature of the disease, more

should be the “talking”

Communication Skills Ppt @ Bec Doms Mba 1st Sem

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