Speak the Same Language
Help Physicians Communicate with Patients to Increase Satisfaction and Reduce Liability
By Robert A. Pelaia, Esq., CPC
Joseph Kipling, an English author and poet, is credited with once saying that words are the most powerful drug used by mankind. Nowhere is this statement’s truth more clear than in physician/patient communication. Frequently, coders wear many hats in the medical setting and often have contact with both physicians and patients. Similarly, coders observe physician and patient interaction and may field patient complaints about the physician or their practice. To help reduce liability and increase patient satisfaction, there are things that can be done to improve communication between physician and patient.
Recently I had the pleasure of meeting with Alan Williams, JD., the author of the best-selling medical malpractice prevention book “Physician, Protect Thyself: 7 Simple Ways NOT to Get Sued for Medical Malpractice.” Mr. Williams has defended physicians, health care providers, hospitals, medical schools, and health care facilities throughout his entire legal career.
Mr. Williams presents convincing evidence in his book showing effective communication in the medical setting is powerful. When questioned about the most important challenges facing physicians today, one third of responding physicians cited medical malpractice insurance and/or claims, according to a study published in the New England Journal of Medicine. Although the thought of malpractice lingers in the minds of physicians and health care providers, studies show subsequent to an adverse medical incident, physicians and health care providers are the ones who have the most control over whether a malpractice claim is filed.
A study published in the American Journal of Medicine concluded physicians who were rated in the bottom third of patient satisfaction surveys had a 110 percent increased risk of having a malpractice claim filed against them as compared to physicians rated in the top third. Another study published in the Journal of the American Medical Association (JAMA) found that physicians without a malpractice claim filed against them more often: laughed and used humor, asked patients their opinions, encouraged patients to talk and interact, educated patients regarding expectations, and spent an average of over three minutes longer per visit with patients, than physicians who previously had multiple malpractice claims filed against them.
A Harvard study reported less than three percent of hospitalized patients with injuries or death directly attributable to medical negligence filed malpractice claims, showing that another factor besides medical quality determines whether a patient files a malpractice claim. Researchers at Harvard, MIT, and the University of Michigan conclude: when physicians and health care providers don’t adequately communicate with their patients after a complication or adverse medical incident, patients often file malpractice claims to determine if any medical negligence occurred. This suggests that physicians’ and health care providers’ communication and interaction with patients is a determining factor of a malpractice claim, even in cases where the physician or health care provider rendered substandard care.
During our conversation, Mr. Williams suggested ways for physicians to improve patient satisfaction and reduce the chance of being sued for medical malpractice. The main recommendations were:
Sit down: Patients believe a physician or health care provider who sits during a portion of the visit has spent more time with them than a provider who stand throughout the visit, although the time spent was exactly the same.
Listen to your patient: On average, physicians and health care providers interrupt a patient just 17 seconds into their complaint description, according to a study published in JAMA. Interrupting a patient so soon communicates that the physician is not interested in hearing what the patient is saying.
Face the patient: Providers should rotate their bodies to fully engage the patient when speaking with them. Studies indicate when physicians or health care providers face more than 45 degrees away from a patient the patient has a negative impression of the visit.
Look at the patient: Research reveals that when speaking to a patient, they must look at you 80 percent of the time and you must look at them 90 percent of the time to fully comprehend what you say. Other studies show only one in six American adults understand rudimentary medical discussions such as a “negative” test result is good, a “malignancy” means cancerous, etc.
Review the chart before entering the room: When two people meet for the first time, each judges the other within the first ten seconds and that judgment is usually permanent—don’t let the patient’s first impression be of the top of the provider’s head as they frantically skim the chart walking into the room.
The Physical Examination (PE): From the patient’s perspective, the PE is the most awkward and embarrassing aspect of receiving medical care. Providers must do all they can to ensure privacy and dignity when performing an examination. A negative and degrading patient experience may convince the patient to file a malpractice claim after an adverse medical incident.
There may be opportunities to incorporate some of these recommendations into your professional career and your patient interactions. Mr. William’s tips don’t cost any money to implement and the return on investment is increased patient satisfaction and reductions in potential liability claims. Speak the same language as your patients and help the physicians you work with do the same.
Alan Williams, JD. is president of Physicians MedicaLegal Prevention, LLC. To contact him please e-mail AlanGWilliams@PhysiciansMedicaLegalPrevention.com.