Healthcare Communication: Effective Techniques for Clinicians

Dennis Novack, MD, founder of DocCom.org, an online communication skills program for hospitals, residency programs and medical schools, discusses the influence of Dr. George Engel, research about the impact of good communication skills and best practices for teaching communication skills. This is the final episode of the podcast. Host Barbara Lewis can be reached at BarbaraLewis@JoansFamilyBillOfRights.com.

Mitchell D. Feldman, MD, MPhil, discusses how to mentor trainees to help them find their purpose and reconnect with their reason for entering the profession; the steps for integrating personal and professional life; the Japanese ikigai as a guide; traits of compulsivity and three questions at the end of the day to reconnect with purpose.

Rob Shochet, MD, discusses relationship centered communication strategy, three important skill sets, how to use the computer in the exam room and other communication techniques.

John Christensen, PhD, describes the medical conditions where hypnosis is used and verbal techniques on how to use hypnosis by talking to patients to improve outcomes.

Homa Dost, MD, a surgeon in Afghanistan discusses the challenges in finding joy in her work.

Elizabeth Morrison, LCSW, MAC, discusses the fascinating research on empathy's impact on health outcomes and three important techniques to convey empathy.

Kathy Cole-Kelly, MS, MSSW, discusses how to identify medical students who need communication remediation and the specific steps she undertakes to ensure they pass Step 2 CS.

In about a quarter of all patients seen in a year have in a mental health disorder of depression, substance use or anxiety. Unfortunately, clinicians aren't trained on what to do. Oftentimes, the physical symptoms signal an underlying mental issue. Listen to Bob Smith, MD, talk about the red flag complaints and how treating the mental disorder helps the physical ailment. His episode on patient-centered interviewing is one of the top three downloaded podcasts.

David Pendleton, DPhil, discusses how to sustain trust, how to address a patient when trust is lost and what to do when is trust undermined.

Howard Beckman, MD, discusses why every clinician needs to know the patients' goals, how articulating goals improves outcomes and helps the clinicians and what the research reflects; he encourages people to continue his innovative research.

Ted Parran, MD, discusses how to deal with the 10 percent of the U.S. population with a substance use disorder, who seek euphoric drugs. How to say NO without jeopardizing the relationship or suffering low patient satisfaction scores, and how to help the patient understand your position and de-escalate a conversation using the PEARLS technique.

Kevin Dorsey, MD, PhD, discusses his experiences with patients when he's his genuine self. He describes his empathy course and his students' reactions years later.

Jeannette Shorey, MD, discusses how to conduct a very efficient patient enounter by learning non-verbal cues, which can save time for a clinician, how to handle mixed messages, how mirroring can influence the patient.

Anthony Suchman, MD, MA, FACP, talks about the three guideposts for developing relationships, the mistakes that clinicians make in developing relationships with patients and how clinician can quickly develop relationships with patients in the era of shortened appointments.

Marcus Engel, MS, CXPX, CSP, discusses the most impactful words, which clinicians said to him, after being blinded in a horrific automobile accident and spending over six weeks in the hospital. Learn more about Marcus at MarcusEngel.com and read his books, "I'm Here" and the Other End of the Stethoscope."

Lisa Sanders, MD, is author of  the popular Diagnosis column for the New York Times Magazine, which inspired the Fox TV program, House M.D. Her previous NYT column, Think Like a Doctor, was the inspiration for a seven-hour documentary series about the process of diagnosis, which is airing on Netflix in August 2019. In 2010 she published the book, Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis. Her most recent book is titled, Diagnosis: Solving the Most Baffling Medical Mysteries. The fascinating podcast conversation is about how to organize the patient encounter, techniques for showing the patient that you're interested in their story, use of video tape with residents and coaching residents.

Elaine Khoong, MD, MS, discusses the rationale for using certified medical interpreters and the astounding error rate when ad hoc (e.g. family member) interpreters are used, how you explain to patients that you want to use a certified medical  interpreter rather than an ad hoc interpreter and resources to help communicate with LEP patients.

Co-author of the DocCom module on high performance teams, Carol Mostow, LICSW, discusses the RESPECT model, an acronym for Respect, Explanatory model, Social context, Power, Empathy, Concerns and Trust. Learn how using a quick technique can change the entire tone of a meeting.   

Susmita Pati, MD, MPH, Chief Medical Program Advisor for the Alan Alda Center for Communicating Science at Stony Brook University discusses what individuals, teams and systems can do to rekindle joy. 

Listen to renowned author and cardiologist, Eric Topol, MD, discuss the five qualities of deep understanding and how clinicians can incorporate them into their practice, using smart phone technology to bond with the patient and crying with a patient.

Well-known book author Danielle Ofri, MD, PhD, discusses how listening affects the quality of what patients say, the golden minute, full frontal listening and how listening impacts diagnostic error and burnout.

Kelly McCutcheon Adams, MSW, LCSW, talks about IHI's Conversation Ready project and end of life conversations. Learn how systems can become ready; the Conversation Ready principles: Exemplify, Connect, Engage and Steward all of which are the foundation for respect; and the advantages for systems to be conversation ready. The IHI white paper and tool kit are available at ihi.org. 

Krista Hirschmann, PhD, discusses a unique methodology for motivating patients to manage their care and helping patients to take control of their situation, so they don't feel so overwhelmed.

Sateesh Arja, MD,MPH, discusses using humanities to inspire empathy; incorporating NURS and PEARLS technique to develop empathy and the challenges to empathy.

Tom Campbell, MD, author of DocCom module on the Family Interview, explains how is the family interview different, the first steps in the family interview, the importance of the genogram, techniques to handle the disruptive family member and the biggest pitfall in the family interview.

Listen to Eric Manheimer, MD, a producer and writer on the successful TV series, New Amsterdam, based on his book, Twelve Patients: Life and Death at Bellevue Hospital, where he was the medical director for 15 years. He discusses how to allow space for the patient to talk; the opening questions to elicit the story, so that clinicians understand what exacerbates the diseases; major factors why patients won't divulge their stories and much more. 

Zeev Neuwirth, MD, MPH, MACP, discusses his proposed shift on how we think about healthcare - less concerned with technical aspects and more concerned with people; the marketing mindset focused on consumers; communication changes when we think about patients as consumers and valued customers; and how this technique influences the amount of time a clinician spends with the "consumer."

Sheira Schlair, MD, MS, talks about how to get ready to listen, the elements of active listening including non-verbal cues, the five stages of active listening and the major mistakes in listening.

Erika Manu, MD, co-author of DocCom Module 23, The Geriatric Interview, discusses how to speak with older patients and why raising your voice is not advised; sitting without back light; working with the team to assess the patient; confidentiality when a caregiver is involved, plus other important techniques.

Richard Kravitz, MD, discusses how technology will impact the request for specialty consultations, three types of responses to patients who want consultations, the barriers for clinicians to talk with patients about their requests and how denial for requests impacts patient satisfaction scores.

Steven Locke, MD, offers recommendations for clinicians who want to use telemedicine. Find out about treating patients across states or around the world, the differences in communicating in person vs. remotely, why certain video platforms can't be used and the biggest mistakes clinicians make in telemedicine. 

Auguste H. Fortin VI, MD, MPH, MACP, the lead author of the book, Smith’s Patient-Centered Interviewing: An Evidence-Based Method, fourth edition, discusses 11 steps for interviewing the patient as outlined in the book, and the biggest pitfalls of the patient interview, such as not setting the agenda, which leads to "door knob conversations." 

Kathleen Kieran, MD, discusses five conflict styles to use with patients and colleagues. 

Julie Crosson, MD, shares 10 tools she teaches to help physicians negotiate the agenda with their patients, which helps improve patient satisfaction.

Sal Mangione, MD, discusses the royal road to diagnosis, where 80 percent of the diagnosis is based on history taking, which he describes like writing a play. 

Marla R. Rowe-Gorosh, MD, discusses how to use the Ask-Respond-Tell technique with patients. She talks about how to be more empathic and why it saves time and how to use the PEARLS technique.

Listen to our expert, Lars Osterberg, MD, discuss the shared responsibility of clinicians and patients for medicine adherence, motivating patients to engage in treatment, the major reasons why patients don't take their meds and how to uncover the truth about patients taking medicines.

Joan Lowery, MEd, discusses the three components of effective listening skills, teachback tips, the relationship between listening skills and empathy, how listening leads to shorter appointments with patients, four barriers for active listening, the characteristics of good listeners and the joy that listening brings to the clinician. For a list of reading material on listening skills, contact Joan at  joan@lowerycommunications.com  

Nicole Defenbaugh, PhD discusses verbal and non-verbal tips for listening with empathy and how empathic listening improves outcomes for the patient and reduces errors, and improves HCAHPS scores and the clinicians' well being. Find out when silence is golden.

Peter Lichstein, MD, FACP, FACH, discusses a core set of steps to end the relationship, what happens when difficult patients need to be dismissed and how to manage saying goodbye to patients.

Julie Crosson, MD, discusses proven techniques on eliciting agenda items and negotiating those items, which helps ensure patient and provider satisfaction.

Cardio-thoracic surgeon, Kathy Magliato, MD, MBA, FACS, recommends that every surgeon be prepared for a conversation about an organ donation and can learn by reaching out to their organ procurement organization. She discusses how to help families in tragic situations and how to close the loop with the family about the organ donation.  

Maria Alkureishi, MD, explains the mnemonic HUMAN LEVEL when using the computer in the exam room. She serves as a primary physician for infants, children and teens at the University of Chicago. She is a leading researcher on incorporating computers in the exam room. She has presented at many national and international meetings on the subject. She has contributed to DocCom Module 14 on Non-verbal communication, which includes important information on computer and electronic medical records. 

Francesca Dwamena, MD, MS, talks about her 20-year journey researching medically unexplained symptoms and discusses how using the mnemonic ECGN for three types of MUS patients helps clinicians communicate with each group.

Douglas Maynard, PhD, discusses how to use perspective display sequence and recommends clinicians ask before telling. He is a sociology professor at University of Wisconsin – Madison. He’s studied the delivery and reception of both good and bad news. He is the recipient of the 2016 George Engel Award for outstanding research contributing to the theory, practice and teaching of effective healthcare communication from the Academy of Communication in Healthcare. 

Listen to "social media's leading physician voice" Kevin Pho, MD, founder of KevinMD discuss rules about using social media, the elevator rule, what to do if you've posted something you wished you didn't, what platforms are best for social media and where you should post personal info.

Clarence Braddock, MD, MPH, MACP, talks about Encouraging Patients to Participate in Shared Decision Making. He discusses his widely used framework for teaching and evaluating the quality of shared decision-making that saves time and lowers the likelihood of malpractice claims. He is the Vice Dean for Education at the David Geffen School of Medicine at UCLA, former Chair of the Board of Directors of the American Board of Internal Medicine and was a founding member of the Academy for Professionalism in Health Care. He is the author of DocCom Module 17 on Shared-Decision Making.

Kelley Skeff, MD, PhD, Co-Director of the Stanford Faculty Development Center for Medical Teachers, discusses why chronological history of present illness is so important, how chronological HPI impacts the clinician's time and the patients' insight into the evolution of their illness. 

Elizabeth Cleek, PsyD, Chief Program Officer & Vice President, and Pia Pyne Miller, MPH, CPO & VP, at the Arnold P. Gold Foundation, talk about Tell Me More: Creating Opportunities for Communication. Learn how to build rapport and connect with patients at the same time combating compassion fatigue.

Damara Gutnick, MD, discusses the world-wide campaign to ask patients, "What Matters to You?" which saves clinicians time, reduces falls and has the potential to improve HEDIS measures. She is the medical director of the Montefiore Hudson Valley Collaborative and an associate professor of epidemiology and population health at the Einstein School of Medicine.

Elizabeth Gaufberg, MD, MPH, Associate Professor of Medicine and Psychiatry at Harvard Medical School, discusses guidelines when confronting challenging boundary issues.