It's nothing short of a tug-of war, with you holding one end of the rope and your patient pulling at the other end. It may sound funny, but it's true. How else would you describe the tension in your routine encounters, where both express more frustration and less satisfaction, with your patient saying,
“I feel no improvement. My back still hurts!”.
And you retort,
“Well, Why don't you stop working in the garden for a few weeks as I've been saying right from the start, and you're supposed to take your medication, and not bring it back for a change.”
Such feelings of mutual resentment are a result of following factors:
- A doctor carries out his profession with laboratory tests and clinical observations, for the patient it means a disrupted life.
- The doctor focuses only on scientifically treating the illness, whereas what the patient needs most is to be heard and understood.
- Some doctors only focus on finding and fixing a disease in a mechanical manner, rather than hearing out the patient.
- Often patients fail to make a complete disclosure of their medical condition owing to embarrassment or any other reason. Nothing can irritate a doctor more.
Whose fault is it? The blame game can go on forever, with the communication eventually coming to a halt. As the Indian proverb goes ‘you need two hands to clap’. Eventually the onus falls on a doctor's shoulder to make his patient listen, comply and be satisfied with the treatment. It does no good to categorize certain patients as “difficult” and develop an unsympathetic view towards their woes just because they don't see eye to eye with you.
While patient knowledge of their own health, conditions, and treatment options has certainly expanded, most still remain careless when it comes to compliance with doctor's instructions. To deal with this, it would help you to remember these three key points:
- Study and utilize the convincing techniques used in other professions (such as sales) to achieve your end.
- If your patient trusts you, he will certainly follow your advice and treatment program.
- Attentive listening and effective inquiry help understand the real health concern.
Believe it or not, there is an element of "selling" required in each profession, including Medicine. You can repeatedly request your patient to check his blood pressure thrice a day, hoping in heart of hearts that he should check it at least once a day. However, be it checking blood pressure, smoking cessation or diabetes management, a doctor can get his patients to change their behavior. This is made possible by compelling them to take action. Here are tips to improve patient satisfaction and enhance patient compliance:
Establish trust: Take care not to trigger psychological fear regarding a health concern. Instead, make sure you convey your message in the right manner and it is understood likewise.
Discover patients' needs: The skill of inquiry is very important. Use it to dig deeper, instead of simply recommending a solution when a patient begins to complain. A patient may say that he feels he's got the flu. While, you may be tempted to simply draw the lab tests and call it a day, the right thing would be to show curiosity and inquire, “ What brings you to think you're coming down with flu?” A discussion with your patient will lead to trust, the foundation of a stronger long-term physician-patient relationship.
Have a Dialogue: Do not go on and on about what a patient can do for better health. No one likes to be preached, and didactic monologues are nothing but boring. If you don't want your words to flow in from one ear and out the other, ask questions to establish a connection with your patient. Your concern about how they deal with their health problem on a day to day basis, and their approach to it, shows that you care and will work to address their concerns in context of their overall goals.
Don't force a Solution too soon: Do not be too keen on moving on to the next step. If you push your treatment too soon, you may instill a sense of mistrust and even anger. First find out whether your patient is ready and then begin to propose solutions that are acceptable to the patient. Ask your patient, if he is okay with the treatment. That would be a perfect “close”.
Always Follow Up: Remember to ask your patients after an interval of every few days or weeks about how your treatment plan is working, and whether they see any change in their condition. Ask them if they would like another appointment for a follow up.
Since, a doctor-patient relationship is central to the delivery of high-quality health care, it is constantly under the microscope. A doctor-patient relationship is extremely sensitive, based on a feeling of mutual trust and confidence. This develops into a friendly rapport, a comfort zone, where the patient has faith in his doctors’ competence and professional abilities, and the doctor expects his patient to follow all instructions related to medication and treatment. Establishing such a relationship is challenging, yet very much possible, and when it is done, you have laid the foundation of a mutually satisfying doctor-patient relationship.