Says, Dr.Venkat Holsambre, Head-Medical Services, Sayhadri Hospital, in an intercation with Ekta Srivastava, Health Technology…
Do you feel that having a good rapport with the patient might be helpful during and after the operation?
A good rapport with the patient is always a good thing irrespective of whether the medical case involves surgery or just a one-time consultation. A physician’s approach to the doctor-patient relationship may affect how engaged patients are in their health care. Patients who share a good bond with their doctor tend togive complete medical history &follow medication schedules and other healthy behaviors.
How do you actually accomplish this? How do you try to instill this will in the patient’s active participation? How do you actually convert the patient?
A doctor has to actively listen while patients are talking about their feelings. Thisis one proven way of instilling confidence in patients. It is important to let your patients know that you understand their condition while treating them.It is best to avoid distractions such as phone calls or messages while a doctor is with the patient.
In a situation where you want to talk to your patient but you do not have that much time to establish this relationship, how do you proceed?
If it is not a very urgent situation the doctor can express sincere apologies and postpone the meeting so that he can attend to other emergencies, and doctor must adhere to the scheduled time after postponing it earlier.
One of the main objectives in communicating with the patient is to establish some sort of human relationship. What is the main purpose of this? Is it primarily to reassure your patient that things will go well?
Establishing a human relationship between a doctor and a patient is vital while treating them. When a doctor is empathetic and compassionate, it ensures a positive outcome.Our experience suggests that positive doctor-patient relationship can have significant effects on health resultsin acute and chronic diseases. Clear and complete communications avoid confusion, save time and help avoid medico legal issues.
There are situations where the patient may ask questions about her health which you would rather not answer at a particular time and, if so, what do you do
Patients always prefer doctors who provide health-related information to their questions. It is advisable that the doctor should answer all the queries of the patients’, as it helps patient to gain confidence about treating doctor.
Does the seriousness of the patient’s condition affect your behavior?
Yes, the doctor has to alter their counseling approach depending on the patient’s condition. For example, if the patient is terminally ill, it is critical to be subtle yet clear.
With different social groups of patients, do you use different conversational styles?
A doctor needs to be sensitive about the cultural background a patient comes from. They should have a fair amount of knowledge about the psychosocial, cultural and economic problems that each of their patients may face during the course of treatment. For example, a doctor should know and respect a patient’s choices such as the choice not to eat certain foods even though they help improve the patient’s condition.
I know you frequently have patients where the risk factors of the eminent operation are especially high. How do you cope with the conflict of need for telling the patient about this high risk factor and, on the other side, the resulting effect of possible discouragement and hopelessness?
A doctor should always inform the patient and their loved ones regarding any risks that a surgery may entail however grave the risk may be. But the doctor should be careful in conveying the information with the proper tone of voice and behavior. This is important because it can help the patient and their loved ones cope with the situation better.
I presume that these conversations, these attempts to communicate and to establish a human relationship with your patient, sometimes take a considerable amount of time. How do you handle this? How do you try to disentangle yourself unobtrusively, if the patient talks too much about subject matters that are not germane to the issue? Just how do you get away, if you need to, if the patient wants to continue the talk?
The doctor has to use their discretion while dealing with a person who talks too much. Doctor can request patient to provide information concisely.
I understand that a hospital is a teaching institution as well. And so we might be interested in how you handle the presence of interns and residents in these conversations? Are they present, while you converse with your patients? To what extent are they involved?
We prefer senior treating doctor to have an interaction with the patient so that patient can be well informed about his condition, treatment, prognosis and can interact with the doctor if he/she has any queries.
In that context, are students of medicine taught the importance and techniques of communication with the patient? And if so, how are they involved?
Such skills are best learned by observations. Observing senior doctors interacting with patient is a good opportunity for interns and residents to learn the fine art of doctor patient communication.
Are your nurses aware of what you are doing, of what you are trying to accomplish? To what extent are they cooperative?
Patient care is a multidisciplinary, team-based approach. Therefore it is important for nurses to be in coordination with doctors while treating a patient.At Sahyadri hospitals, we strive to keep open communication channels between all staff so that the patient care is streamlined.
As a final question, I would like to come back to what we touched upon at the beginning of this interview. Can you really notice the medical benefits of what we sociolinguists call therapeutic conversation?
Therapeutic conversation focuses on the emotional and physical health and needs of a patient.When doctors employ conversation style approach to deciding treatment with a patient, it really has better health outcomes.