Doctor/Patient Interactions

Malpractice

Knowingly not following standard of care

Medical Socialization

Process of being taught how to behave in medical community

Voice of Medicine

Vocab and terminology

Theory of Socialization

Tear you down —> build you up into what they want

Assimilation

Make you same as everyone

Selection process

Weed out those not fitting in

Socialization Processes

Loss of identity

Privileged status

Many responsibilities

Med School Benefit

Learn to perform in high-stress situations

Med School Reform

More patient-focus

Limit on shift hours

Problem-Based Learning

Situational questions

Professional Influences on Caregivers

Time constraints

Loss of Autonomy

Psychological Influences on Caregivers

Lack of maturity

Self-doubt

Satisfaction

Fulfillment from impacting lives of others

HAVE to do job correctly

Defense against mistakes - 5 steps

More serious = more personal

Simple and truthful

Let patient talk

Assess how news is received

Respond with empathy

Burnout symptoms

Emotional exhaustion

Depersonalization

Reduced sense of personal accomplishment

Burnout causes

Conflict

Emotions

Bad communication

Workload

Physican-centered communication

Dominant form, but shifting

Physician in charge

Talk more than patients

Patient-centered communication

Rising

Patient drives conversation

Physician assertiveness

Showing your power = unnecessary

Patronizing behavior

Seen more with minority patients

Treating as “less than”

Power differences

White coat effect

Therapeutic Privilege

Withholding information for patients’ good

Can be unethical

Depends on culture

Solutions - Collaborative Communication

Doctor and patient work togetherSo

Solutions - Motivational Interviewing

Non-judgmental

Patient-centered

Used when patients = resistant to changes

Get info from patient about what motivates them

Cultivating Dialogue - Nonverbal

Look interested

Use touch appropriately

Pay attention to patient nonverbal cues

Cultivating Dialogue - Verbal

Start friendly

Open-ended questions

Don’t rush/interrupt

Determine real issue BEFORE exam

Ask for feedback

Give reassurance

Treat people as equals

Environmental Restructuring

Ex. windows that open/overlook nature

Telemedicine - Pros/Cons

Pros - more/open comms, increased access to care, efficient

Cons - health disparities, privacy concerns

What to do as a patient

Be assertive about your own care

Patient Socialization - Ambiguity

Expectations based on TV

Doctor role to guide patients

Voice of Lifeworld

Patients use feelings and everyday experiences

Patient Characteristics

Disposition

Communication skills/ability

Nature of illness

What Patients Want

Attentiveness

Respect

Convenience

Sense of control

Moderation

Privacy

Rates of Noncompliance

50-60% of patients follow doctor instructions

Noncompliance Reasons

Impossible/impractical

Disagreement

Denial

Lack of effective communication

Difficult Patient Tips

Take complaint as chance to grow

Paraphrase

Put time into knowing the patient