Exams Predict Which Doctors Will Have Problems Communicating

By Cheree Cleghorn, Editor

The Journal of the American Medical Association (JAMA) has a study which asked if “patient-physician communication examination scores in the clinical examination scores predicted future complaints in medical practice.”

Yep. They sure do.

The context described for the study: “Poor patient-physician communication increases the risk of patient complaints and malpractice claims. To address this problem, licensure assessment has been reformed in Canada and the United States, including a national standardized assessment of patient-physician communication and clinical history taking and examination skills,” the authors wrote. Patient complaints made to medical regulatory authorities were used as the authors’ definition of “complaint.”

The study was done in Canada. All the doctors taking the licensing exam between 1993 and 1996 were followed up until 2005, including the first 2 to 12 years of practice, the JAMA abstract says. There were 3,424 physicians studied.

What Does This Mean To You?

It’s smart to listen when patients rave about a doctor. Ask them more, even if you don’t need that kind of doctor at the time.

When you are asking patients about their doctors, zero in on how well current patients think the doctor communicates with them.

• Are they generally happy with the doctor’s overall manner and style of communicating?
  
• Does the doctor explain what is to be done before an examination and during it?
  
• Does the doctor work to make it clear to them what the problem is and what the plan for treatment is?
  
• If the patient were unconscious, and this doctor was the only one available to make a decision on the patient’s behalf, would the patient feel comfortable that this doctor would act in his or her best interests?
• Have there been any misunderstandings? If so, how were they worked out?
  

Citation: Journal of the American Medical Association, “Physician Scores on a National Clinical Skills Examination as Predictors of Complaints to Medical Regulatory Authorities JAMA. 2007; 298:993-1001

Dealing with 'Difficult Patients':

In real medical practice, dealing with 'difficult patients' are seen almost daily. 'Difficult patients' are ordinary people who come to your health institute, whatever is that, because they have to, not because they want to. Sometimes, they have even been brought in unwillingly by a family member or a friend. They come in with their vast range of different personalities, cultural background, and current emotional state.

Being in a health care facility adds more worries and stresses due to lost time, expenses, and more importantly losing control. People are usually in control of what they have to do now, well at least they think so. But on the moment they put their feet in front of your registration desk, they lose this control. We, the strangers, take control!... We give instructions and orders to follow starting right from that registration desk... Give me your ID, .. insurance,.. wait there,.. sit there,.. you have to wait,.. take off your cloths,.. touching them, .. etc.

So, by the time of their medical encounter with us, the healthcare providers, whether that is a doctor, nurse, or a tech, they are already up on the edge in their stress and comfort levels. And guess what, for them because we are taking care of them at this moment, they think that we are the highest ranking authority here and thus have to receive all the blame and deal with them in these 'difficult patient' situations. Although, some of these people will look like trouble makers by personality, most of the exaggeration is due to the building up stress and worry, or simply part of their illness!

Dealing with 'difficult patients' in medical encounters needs a lot of communication skills to sooth them and calm them down or to let them at ease and open for effective communication. However, although this is part of our duty in addition to establishing rapport and friendly environment, it is not our goal in medical encounters! We are not social workers. Our goal is to figure out what is going wrong with them physically and psychologically or perform some medical procedures in order to help them. These good communication skills are not the goal, they are wonderful magical means to achieve our goal, the patient well being. Communication skills are our vehicle to take a thorough medical history, perform accurate safe physical examination, and assure patient compliance, and yet efficiently in respect to our time and resources limits.

As you may realize now, it is important to learn the specific communication skills to deal with these 'difficult patients' in real life. This will make us friendly caring clever healthcare providers and build a good reputation while staying thorough, focused, organized, and efficient. This is what successful considerate professionals know very well!

'Difficult Patients' scenarios:

The Silent or Reticent patient.
The Rambling or Talkative patient.
The Vague patient.
The Angry patient.
The Depressed or Sad patient.
The Denial patient.
The Anxious patient.
Patient with Somatization.
The Dependent and Demanding patient.
The Dramatic or Manipulative patient.
The Long Suffering, Masochistic patient.
The Orderly and Controlled patient.
The Manic, Restless patient.
The Guarded Paranoid patient.
The Superior patient.
Breaking bad news.
Caring for the dying patient.
Conflicted Roles.
Solving Conflicts.

Do you want to be distinguished?

"How To Unlock Difficult Medical Encounters" is an ebook that helps you recognize and deal with 'difficult patient' medical interviews and issues. It provides proven steps to follow to unlock 'Sick encounters'!. Short, condensed, well organized and easy to read and memorize.

Almost every day, you, medical students, residents, nurses, and physician face 'Difficult Patients' in your clinical practice. All OSCE exams organizers, medical schools, and nursing schools include difficult to deal with patient scenarios in their exams to test your communication skills and reactions.

Limited resources are out there to help you deal with these 'Difficult Patients'. Most of these resources deal with the etiology behind these situations hoping that the understanding of the etiologies will help you to figure out the right ways to deal with them! They are long and its hard to come out with a workable plan out from them. A plan that we can acquire, practice, and implement and integrate it with our current work practices in a short time with less effort.

We already haven't much of time. But you realize that improving our skills will refresh our interest in our profession, reduce work stress, and improve our assessment with our higher superiors.

Learning to take medical history or perform a physical exam or a procedure is so easy. You will be amazed how well your colleagues sre doing with these clinical tasks. There are tons of resources to train yourself these skills. But what about communication skills with 'difficult patients'? You will be amazed how bad your colleagues are doing with these clinical tasks that need special communication skills!.. Imaging yourself mastering these skills!..

Definitely, you will be distinguished from the crowd!... Your colleagues will ask your help to teach them your secrets to master these situations!... They will recommend that you, the expert with a human touch, to deal with such situations!.. Your OSCE examiner or clinical supervisor will admire you.

This is the first ebook that is written focusing on techniques, strategies, and practical proven steps to help you deal with 'Difficult Patients'. It is focused on practical tools ready to learn, adopt, and implement to improve your way of dealing with difficult patients in both OSCE exam scenarios and real life settings.

You have no time to read and you need to learn quickly proven skills. For just US$ 17, you can download to your desktop computer or laptop computer and start aquiring and practicing it now!

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ACT NOW !!.. Be distinguished!

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