So
many things are taught in medical school about communication, examination and
disclosing information to the patient. Here I would like to share some points,
which I learned during my residency.
1. Give privacy to your patient: Close the room
when the patient walks in. Ask your non-medical staff/ assistant to wait
outside while talking and examining the patient. This will also help to prevent
the tendency of patient to talk in a low voice and as a result, come closer to
the doctor’s face during conversation. Always try to keep a safe distance from
the patient while talking.
2.
Request the patient and attender to sit: I have
always watched that the patient and attender feel comfortable and happy when I
ask them to sit before starting conversation. Most of the patients will sit
even if you do not ask them to. But offering a seat helps to make them open up.
People have told me, how good they feel, when the doctor offers the seat.
3.
Elucidate the history with some leading
questions: We have been always taught to avoid leading questions while taking
history. But in practice, there will not be sufficient time to hear the
elaborate stories of our patient. It is unrealistic to expect information in
the form of ‘presenting complaint x
duration’ format from the patient. Most of the patients will be anxious and do
not know where to start. Often they start with the least bothering symptom and
half the time, they are in a hurry to show the ultra sonogram or CT scan report
even before starting the conversation.
4.
Washing hands and wearing gloves: Hand hygiene
is very important, not only for preventing infections, but also as a part of
good manners. Ensure you wash or use an alcoholic antiseptic solution before
and after touching a patient. Wear examination gloves whenever required.
Examining the patient without such prerequisites is disrespecting the patient.
Washing hands and using antiseptic lotions help to build confidence in the
patient about your safe practices. After all, no one wants to put himself or
herself before knife under a careless surgeon.
5.
Never turn your back until the patient gets down
from the examination table: Our professor taught this dictum. It may seem
silly, but if you are not in the habit of doing it, you will see your patient
falling from the examination table now and then. The examination tables are
made narrow and tall for the comfort of examining doctor.
6.
Explain the disease to the patient and treatment
options: This does not need further elaboration because it is a thing, which we
cannot miss. There are many ways to do it and the polite, lucid explanation is
always the best.
7.
Refer the patient to appropriate specialist: Try
to refer the patient to a person who has the knowledge and skill to manage
their condition, if you are not the person to do it. Rather than just
referring, you can tell them the easiest way to reach that specialist. I
believe that, fifty percent of the disease gets resolved as soon as the patient
reaches the right person to treat it.
I
haven’t described anything new. But making a conscious note of these things help
to improve the patient interaction over a period of time.
