Clemson University
Clemson, S.C.
Laurens County Hospital
Clinton, S.C.
A Clinical Scenario
For the past three years, patient satisfaction in U.S. hospitals has been in an unprecedented decline secondary to a gradual diminution in communication with doctors and vague information about medication and care transitions (JAMA Health Forum 2023;4[8]:e232766). In other words, there has been a significant decline in good clinical skills, which are defined as the capability to effectively communicate with patients and their families (Yale School of Medicine, Clinical Skills, 2022). Clinical skills also consist of a provider’s ability to be empathetic, understanding, and accepting of the fact that they are treating a person and not a disease. There are several clinical skills that physicians need to remember: Providing respect, kindness and compassion are crucial to patient satisfaction.
Physicians can show respect to their patients by being on time, avoiding complex medical terminology and demonstrating active listening. It is true that they have a great deal on their plates: making rounds, seeing patients in the clinic, ordering labs, interpreting results, performing procedures, charting and completing an immense amount of “administrivia”; however, clinical skills must be practiced.
Being on Time
Punctuality is a significant sign of respect. According to the American Association of Colleges of Nursing, better patient outcomes and reduced suffering result from mutual respect between patients and their healthcare providers (Health Serv Manage Res 2011;24[4]:163-169; Online J Issues Nurs 2018;24[1]). Knowing a physician cares enough to be on time brings comfort and assurance to the patient that they are in good hands.
Avoiding Medical Jargon
Minimizing the use of excessive medical terminology is equally important. Most of the population has limited health literacy, which presents noteworthy pitfalls in patient care. According to the Institute of Medicine, health literacy is “the degree to which individuals have the capacity to obtain, process and understand health information and services needed to make appropriate health decisions.” With limited health literacy, patients are more likely to mismanage their illnesses, which could worsen their condition or lead to a trip to the emergency department (Perm J 2008;12[3]:67-69). When physicians speak medical jargon to their patients, this only worsens their health illiteracy. Physicians must remember to explain medical jargon in language that is appropriate for patients to improve their health and understanding.
Active Listening
Demonstrating active listening is also an effective way to show respect. Sir William Osler, the founder of internal family medicine and the developer of clinical medicine education, once said: “If you listen to patients carefully enough, they will tell you the diagnosis.” In other words, a physician needs to practice active listening, which is done by being attentive, asking open-ended questions, requesting clarification when necessary and showing empathy.
Avoiding ‘The Rushed Feeling’
As important as it is for a physician to show respect to people under their care, physicians also should create a reassuring environment for the patient so that they do not feel either intimidated or rushed by the provider. Simple body language, such as sitting down on the bedside or pulling up a chair to sit near the patient, gives the patient the impression that they have your undivided attention. Sitting down leaves the patient remembering “my doctor spent plenty of time with me.” Sitting at the bedside has notably improved patient communication skills and patient satisfaction (J Gen Intern Med 2022;37[12]:3038-3044).
In addition, a physician is seen as an authority figure, and it may be subtly intimidating to the patient if someone of authority is towering over them. It also may give the impression that the physician is in a rush, making patients feel their provider does not care for them. Simply moving from a standing position to a seated one communicates empathy and enhances a connection between the physician and patient.
Because one of the most common complaints patients have about their clinical experiences is that the doctor made them feel rushed, anything we providers can do to give even the impression of having spent extra time will dramatically increase patient satisfaction. One technique we have used to do this is to verbally acknowledge that the patient’s time is valuable. Here is an example of what may be done as the encounter with a patient is coming to a close. Instead of rushing them to the door or passing them off to the nurse, say something like: “Do you have time for me to tell you a little more about …?” Almost always, the patient’s eyes light up with delight. A 30-second quip will markedly improve the patient experience.
Providing Comfort, Reducing Anxiety
Lastly, physicians should provide comfort to their patients. Simple ways to ensure comfort include using appropriate physical contact and/or playing music in the office. Physical contact with the physician almost universally makes people feel content as it releases endorphins, such as “the bonding hormone” oxytocin (Dignity Health Apr 28, 2018. bit.ly/3wPvEcK). Other hormones, such as dopamine and serotonin, contribute to a pleasant feeling and also are released during physical contact. Physical touch connects the patient and healer, allowing for a more trusting relationship.
Playing music in the office can create a calming atmosphere for the patient. Anxiety surrounding a physician visit is not uncommon. Music can lower levels of cortisol. By playing music in the office, the physician can help patients feel more at ease, and the calm, peaceful patient can then effectively communicate their concerns. Now that streaming music and Wi-Fi access are nearly ubiquitous, consider asking the patient what music they would enjoy hearing during an office procedure. A small Bluetooth speaker and a smartphone make that level of patient care easy to provide.
Practicing simple clinical skills that make a patient feel respected and welcome will enhance the experience of both the physician and patient. Healthcare providers must prioritize making their patients feel as comfortable as possible to deliver a personalized and exceptional experience—one that the patient will then brag about to their family and friends, saying, “I have the best doctor!”
This article is from the July 2024 print issue.