What are the 4 benefits of a good interview?
- Symptom resolution
- Improved med compliance
- Increased Trust
- Decreased Risk of being sued
What is most important to determining whether a physician will get sued?
What reasons are typically cited during malpractice litigation?
Quality of the doctor-patient relationship
- didn't listen
- didn't return phone calls
- didn't spend enough time
- didn't answer questions
- didn't respect patient's condition
What are patients looking for in physician?
What AREN'T they looking for?
- treats patient with respect
- listens carefully
- easy to talk to
- spends enough time with patient
Patients are less concerned with the technical quality of their care
What is the biopsychosocial model?
Interplay of the patient's biological, psychological, social, and spiritual systems contributing to the health (or disease) of the patient
What are the four models of doctor-patient interaction?
Describe each model.
- autocratic, doctor makes decisions for the patient
- doctor dispenses information, but the patient is the ONLY one making the decision
- Doctor and patient share decision making based on knowledge of patients' values
- Doctor shares information, but advocates for a particular action
What is transference?
What is countertransference?
Transference is an unconcious process in which the patient imposes aspects of past relationships into the doctor-patient relationship
Countertransference is the unconcious process in which the doctor imposes aspects of past relationships into the doctor-patient relationship
According to Othmer and Othmer, what are the six strategies for developing rapport?
- Put patient at ease
- Express compassion for patient pain
- Become an ally to the patient
- Show expertise
- Establish authority as physician, therapist
- Balance roles of listener, expert, and authority
What is the "content" of an interview?
What is the "process" of an interview?
Content is what is literally being said
Process is any non-verbal or unconscious reactions
When are open-ended questions most effective?
When are close-ended questions most effective?
Most effective at the beginning of the interview to build rapport
Most effective at the middle/end of the interview to establish a diagnosis
What is facilitation?
What is reflection?
Facilitation is verbal or non-verbal means of encouraging the patient to continue their story (EG nodding head, "go on" etc)
Reflection is supportive restating and summarizing of the patient's concerns
What is clarification?
What is redirection?
Clarification is gentle questioning of the patient to clarify a point.
Redirection is an attempt to move the patient back to the topic. Should initially be polite, but may need to be blunt.
What are the best uses for silence during an interview?
What is the best way to use confrontation during an interview?
What is summation?
Use silence sparingly to give the the patient permission to continue
Sometimes necessary, but should be done with the "Columbo" approach (fat, dumb, and happy)
Summarizing the information the patient has given you.
What is explanation?
What is Transition?
Using layman's terms to concisely explain the diagnosis and the therapy.
Smoothly moving from one topic to another
What is positive reinforcement?
Letting the patient know that they can share anything with the doctor, no matter how painful or embarrassing.
What is self-revelation?
What is reassurance?
What are the dangers of using these techniques?
Self-revelation is telling the patient information about yourself to build rapport. It is important to know where the line of a professional relationship is though and not overshare.
Reassurance is communication that puts the patient at ease. It is important not to give false reassurance, which is essentially lying.