An excellent new study from Canada’s Manitoba province explores the factors in successful interaction between patients and their physicians. I’m interested in what you, our readers, think makes for patient-physician communication success–or failure.
The study is featured in the Journal of Participatory Medicine, the great new resource we’ve mentioned previously. Authored by Brenda L. Lovell, Raymond T. Lee, and Celeste M. Brotheridge, the study report assesses the relative importance of many factors. Physicians in the study identified three major barriers to communication:
- patients’ failures to follow through with treatment plans or lifestyle changes
- insufficient time for patient visits, and
- patients’ failures to understand the diagnosis.
The major barriers to the patient and physician’s shared understanding, according to the physicians, are:
- patient presents too many problems
- patient’s history is rambling and disorganized, and
- insufficient time.
The major barriers to shared decision-making by the patient and physician, according to the physicians, are:
- patient does not appear to trust physician
- patient is uninterested in self-care or health maintenance, and
- patient does not want to participate in a partnership with the physician.
There are lots of limitations to this study, as the authors note. (There also are lots of limitations to our own brief summary, above.) But, it’s important for patients to have a sense of the pitfalls that physicians are on the lookout for. If you immediately bring one or more of these barriers to the doctor’s mind, he or she is likely to dismiss the possibility of successful communication–and to hurry on the next patient.
After all, what would you do if you had to see dozens of clients every day and the client in front of you gave the appearance of being uncooperative?
In essence, that’s what our book “Make the Health Care System Work for You!” is all about. We suggest practical ways to become engaged and help create a fruitful partnership with your doctor. We think the patient is one side of the communication equation and can’t rely on the doctor to do all the work.
The major limitation of the Manitoba study is that it only presents the doctor’s viewpoint. We need the patient’s viewpoint. We need to know what pleases or annoys patients who seek a shared understanding and shared decision-making.