Ustun 2017 doctor patient relationship
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Transcript of Ustun 2017 doctor patient relationship
Objectivesofthislecture
Attheendofthelecturethestudentshouldbeableto
1. Understand keyaspectsofdoctor-patientrelationship
2. Applyself-evaluationonbeingobjective,neutralandnon-judgemental
PatientBillofRights
• Righttoaccesscare• Equaltreatment• Demandinformation• Righttochoosedoctorandinstitution• Confidentiality• Informedconsent• Security• Religiousrespect• Humanvalues• Accesstovisitors
Thedoctor–patientrelationship
• keytothepracticeofhealthcare• essentialforthedeliveryofhealthcare
• Humanrelationship– social&psychological
• Knowledgeexchange:problem-identificationandsolving
• thediagnosisandtreatmentofdisease
• Improvinghealthcultureinthesociety
Whatmakesa“good”doctor?
• Listening• Interest– concern• Respect• Flexibility• Knowledge• Subjectmatter• Generalexamination– interviewtechniques• Symptomaticreadingofthepatient• Relationshipreading
SHOCKINGFINDINGSfromRESEARCH
• 60%oftapedinterviewsshowedinterruptioninfirst20seconds
• In50%ofthecases:doctorsandpatientsdidnotagreeonthekeyproblem
• 80%ifthecasescouldnotadequatelyrepeattheprescription
EMPATHY
• Understandingtheother’scondition• Feelinginother’sshoes• Seeingthesituationthroughtheireyes• Donotjudge– justtrytounderstand• Recognizetheirmotives• Ask– communicate- discover
Emotions
Doctor– Patientencounter
Cognition
• Pleasure• Fear• Anger• Sorrow• Disgust• Surprise
• (Anxiety)• (Trust)
ADoctorshould…
•beabletorelatetodiverserangeofpeople• Understandtheirpersonality• Communicate withthem
•understandthepsychological– behavioralandsocial aspectsoftheirlives
Extroversion Introversion
Where do we vest our energy?
Speed Reading
How do we make decisions?
Thinking Feeling
How do we organize our world?
Judging Perceiving
How do we take in information?Sensing Intuition
Describe“a”doctorpatientrelationship
• Whatmakesa“good”doctor?
• Whatmakesthepatient“satisfied” ?
• Rightdiagnosis– rightintervention– rightbehaviour ?
• Dopatientshavetherighttochoosedoctors?
• Dodoctorshavetherighttochoosepatients?
DOCTORLow Control High Control
PATIENT
LowPart. Default Paternalism
Omnipotence
HighPart. Consumerism Mutualbalance
ChangingRoleofDoctors
• Biopsychosocialapproach
• Facilitator/Listener
• BehaviorChangeExpert
• Patient-CenteredCommunication
Communication
YOU• Think• wishtoexpress• thinkyouhavejustexpressed• youexpressed• …
OTHERONE• wants tohear• Actuallyhears• wishestounderstand• understands• …
RequirementsofagoodDoctor-PatientRelationship
Doctor• Accessible– available• Reliable– trustworthy• Standardofcare• Willingnesstohelp• Goodevaluation– judgement• Communicateeffectively• Objectivity• Neutrality• Non-judgemental• Non-discriminatory
Patient• Takeresponsibilityinownhealth• Provideaccurateinformation• Collaboratewithprovider• Followtreatment
Whatisyourownevaluation:Whateffectsyour …
1. Objectivity?
2. Neutrality?
3. Non-judgmentalstance?
• Gender– sexualpreference• Age• CountryofOrigin• Socialstatus• Typeofillness
• HIVstatus• Smoking• Alcoholintake
• EconomicStatus• ….
Summary:
• Makeyourselfavailable,accessible andinterested inyourpatients• Avoiddistractions
• Listenintensely• Observeintelligently• Makeempathywithyourpatientsandusethisinunderstandingthem• Communicateindailylanguage• Preferopenendedquestions• Trybeingobjective– neutral– non-judgmental