Recommendations for a Healthy Physician - Patient Relationship

Risk management begins the moment a professional relationship is established with a patient. The understanding by, compliance by and satisfaction of any patient ultimately depend on oral and written communication. The following general points will be helpful as you build each physician-patient relationship. The result should be a mutually rewarding experience for both the physician and patient.

1. Introduce yourself to every new patient and describe your relationship with other health care providers, such as students, nurses, physician assistants, residents, fellows, consultants, and the relevant attending, referring and primary care physicians.
2. Address your patients appropriately and modify your greeting as your relationship progresses. It is best to begin with formal titles; then, if both sides are comfortable with doing so, shift to something less formal. If possible, use a translator to help communicate with patients who speak a foreign language with which you are unfamiliar.
3. Sit down close to the bedside, if possible, and make frequent eye contact. Be attentive to the patient's non-verbal communication. Offer your own encouraging feedback through gestures and words.
4. Begin with open-ended questions to allow patients to talk of their symptoms, previous care, impressions of their prognosis, and the role of family members in decision making. Focus questioning to obtain specific information.
5. Ask for the patient's expectations of your care. Involve the patient and family (if the patient so desires) directly in the care as much as possible.
6. Limit the use of medical jargon. Relate information at an appropriate level of understanding for the patient. Use pictures and models to help explain complicated concepts.
7. Provide emotional support to grieving, anxious, frightened, or depressed patients. Reassure your patients that you will be helping them throughout the course of their medical problems and will be available to answer questions as they arise.
8. Be punctual for meetings with patients and families.
9. Avoid criticizing another physician's management of your patient with words or gestures. The other physician may have had different data and resources available at the time of initial decision making. Medical problems usually appear more clearly when viewed retrospectively. Malpractice cases have often been precipitated by criticism of this kind and you may find yourself an expert witness based on your comments.
10. Never guarantee the outcome of a treatment, orally or in writing. Prepare patients for any pain, discomfort, and disability that they can reasonably expect from diagnostic and therapeutic interventions. Make clear the necessity and effectiveness of intervention if disability is the expected result. Document these discussions.
11. arise.
12. Send a written summary of your findings and the medical plan to your patient's primary physician following a hospital stay or major office visit. When multiple clinicians are involved, clearly delineate roles among the parties and convey this to the patient in a manner that will facilitate coordination of patient care.
13. When it is necessary to discuss fees, be open and frank concerning the cost of care. Where appropriate, help educate patients concerning today's often confusing health care system. You might consider providing an estimate of the cost of an anticipated course of therapy or operation. However, be careful not to make representations of the prospective cost of hospitalization or other services not within your control.
14. Be aware of the state and federal laws regarding health care law for your patient population. Information on childhood vaccinations, prenatal nutrition programs, Medicare benefits, and other topics are vital for proper care of your patient.
15. Be sure your office staff and answering service treats the patient with courtesy and consideration.