Doctor-Patient Communication

Division of Bioethics Humaniora Medicolegal and Professionalism

School of Medicine University of Sumatera Utara
Things to know
Things to know
Definition
Things to know
Rapport
 Things to know
Models of interaction
between doctor and patient
 Things to know
Good doctor-patient
communication
Things to know
Truth telling
Things to know
Case study
Definition
Definition
Latin word
Definition
Communicare
 Definition
To make common
To share
 Definition
Process/ Act transmitting
essage from sender to receive
through channel and
interference of noise
Rapport
 Rapport
Othmer and Othmer
 Rapport
6 strategies to achieve rappor
 Rapport
the patient and yourself at e
 Rapport
d the suffering-Show compass
 Rapport
Assess insight-Become an ally
 Rapport
Show the expertise
 Rapport
Establish leadership
 Rapport
Balance the role
Models of interaction between
doctor and patient
Models of interaction between
doctor and patient
The paternalistic model
Models of interaction between
doctor and patient
The paternalistic model
Doctor knows the best
Models of interaction between
doctor and patient
The informative model
Models of interaction between
doctor and patient
The informative model
octor dispenses informatio
Models of interaction between
doctor and patient
The interpretive model
Models of interaction between
doctor and patient
The interpretive model
octor who has come to know
their patients better
make recommendations
Models of interaction between
doctor and patient
The deliberative model
Models of interaction between
doctor and patient
The deliberative model
Doctor acts as a friend
or counselor
Good doctor-patient
communication
 Good doctor-patient
communication
Two-way communication
 Good doctor-patient
communication
Two-way communication
Open-ended questions
 Good doctor-patient
communication
Two-way communication
Avoid clinical and technical
informations
 Good doctor-patient
communication
Two-way communication
ncourage patients to engag
medical consultation
 Good doctor-patient
communication
Biopsychosocial content
 Good doctor-patient
communication
Biopsychosocial content
Discussing end-of-life issues
 Good doctor-patient
communication
Biopsychosocial content
Delivering bad news
 Good doctor-patient
communication
Biopsychosocial content
closing errors/ adverse eve
 Good doctor-patient
communication
Nonverbal communication
 Good doctor-patient
communication
Nonverbal communication
How the communication
is spoken
 Good doctor-patient
communication
Nonverbal communication
Approppriate body posture
 Good doctor-patient
communication
Nonverbal communication
Maintaining eye contact
 Good doctor-patient
communication
Nonverbal communication
Tone of voice
Good doctor-patient
communication
Issues
Good doctor-patient
communication
Issues
Practicality
Good doctor-patient
communication
Issues
Culture
Truth telling
 Truth telling

Provision of information
 Truth telling

Provision of information
Not simply to enable patient
to make informed choices
 Truth telling

Provision of information
To inform them
about the situation
Truth telling

Ethics
 Truth telling

Ethics
ot telling the truth can har
patients in many ways
Truth telling

Law
 Truth telling

Law
The right of patients
o gain access to their own M
Case study
A 47-year-old man was diagnosed with metastatic lung cancer.
Within two weeks of diagnosis he was admitted with an acute
abdomen and needed to have emergency abdominal surgery due
to the cancer. He developed postoperative bowel delay and opted
to be a DNR do not resuscitate. When the doctor visited him
three days post operatively, her hemoglobin was anemic at
7.5grams/dl. The doctor called the resident and asked him why
the patient was not transfused with blood; the doctor got the
response that patient is a DNR.
The surgical team had decided that as a DNR, he did not need
blood. At that point his post op recovery was not especially
unusual. He had not been asked about a blood transfusion.
Subsequently he was asked and got about six units of blood. His
seventeen-year-old daughter was in a school out of state and it
was important for him to stay alive for a few days to see her. He
eventually went home about two weeks later very much
cognitively intact signed into hospice.
Conclusion
 Conclusion

With good rapport

 Conclusion

omes good communicatio

References
1. Slater T. A definition and model for communication. Available
at: www.infoamerica.org/documentos_pdf/ slater01.pdf
2. Othmer E, Othmer SC. The clinical interview using DSM-IV. Vol
1. Fundamentals. Washington, DC: American Psychiatric
Press, Inc, 1994.
3. Sadock BJ, Sadock VA. Kaplan & Sadocks Synopsis of
psychiatry behavioral sciences/ clinical psychiatry. 10th ed.
Philadelphia: Lippincott Williams & Wilkins, 2007.
4. Fang NL. Working toward the best doctor-patient
communication. Singapore Med J 2011;52(10):720.
5. Hbert PC, Hoffmaster B, Glass KC, Singer PA. Bioethics for
clinicians: 7. truth telling. Can Med Assoc J 1997;156(2):225-
8.
6. Tata Z. Bioethics and bedside communication in daily patient
interaction. Available at: http://ehln.org/?p=13918
Thank you
One more thing
Always remember in your lif
Beneficence
Nonmaleficence
Justice
Autonomy