Discover how you can improve the healthcare provider-patient relationship and reduce patient claims by effectively using verbal and non-verbal communication skills.
Working in healthcare means working within professional standards to ensure patients receive quality care. However when patients are faced with negligence in standards of care, surprisingly only a few patients will initiate a malpractice claim.  Research has found most patients are more likely to initiate a malpractice claim if there is a breakdown in communication in the healthcare provider-patient relationship. 
The healthcare provider-patient relationship is fundamental in medicine, relying on trust and rapport between healthcare providers and patients to communicate and make informed decisions. Ineffective communication with patients can shift the balance in the relationship and negatively impact on a patient’s perception in the quality of care received.
Patient perceptions of healthcare communication
A large survey of physicians in the US, involved in litigation, found that their own perceptions of their communication skills in the healthcare provider-patient relationship differ greatly from those of their patients. Prior to experiencing a patient claim, most physicians believed they had an open, respectful and honest healthcare provider-patient relationship. However, the survey found that only about half of their patients who sued thought the relationship was open and respectful. 
In Asia, studies of the healthcare provider-patient relationship have found patients’ dissatisfaction with Southeast Asian cultural influences on paternalistic or one-way style of communication. 
Paternalistic medical communication is associated with Southeast Asian cultural norms of social distance, respect for social hierarchies and avoiding close relationships in clinical settings. However Asian patients have demonstrated a preference for an open, communicative partnership with their healthcare provider that uses two-way communication, even if it doesn’t feel comfortable for Asian culture. 
By investing time in essential communication skills you can achieve greater patient satisfaction and compliance, allowing you to give your patients optimal treatment and management preferences.
Verbal communication is the most obvious form of communication and encompasses the words you use to communicate information to your patients. Using effective verbal communication with patients is an essential skill for healthcare providers.
By asking questions during your discussions with patients, you can ensure a two-way dialogue that encourages your patients to tell their story bringing out additional issues or concerns. Consider asking your patients open-ended questions such as, “what has brought you in today?” or, “can you tell me more about your chest pain?”. You could even ask your patients probing questions to encourage them to open up and talk such as, “is there something else you wanted to talk about today?”
Other forms of verbal communication can also put your patients at ease when used appropriately. You can inform and educate patients on what to expect, use humour where appropriate and check your patient’s understanding of any medical treatments.
Non-verbal communication is just as essential as verbal communication and acts as a complement to the words you use.
Consider maintaining eye contact with patients or nodding while patients speak to suggest availability and attentiveness. Make sure you’re not focusing on external distractions such as checking your mobile phone or looking at computer screens while patients are talking.
Your posture is also another form of non-verbal communication and helps express non-judgment so your patients feel comfortable in the relationship. An open, attentive posture means not having your arms crossed or folded, facing your patients and not fiddling with items while speaking.
When non-verbal communication is used effectively, it can ensure your patients do not feel rushed or ignored.
Having a genuine interest in your patient’s problems means taking time to listen when they speak. Use silence to allow them time to talk about their feelings and fears and be mindful of respecting patient autonomy in making decisions.
Active listening is a great communication technique that either you or your patients can use. It requires the listener to repeat what they have understood of the discussion. You could find out their expectations and ensure you have correctly heard your patient’s health concerns.
Patient empathy is an important skill to master when communicating with patients, especially if clinicians find it difficult to remain empathetic and not sympathetic.
Empathy encompasses your verbal and non-verbal communication skills for patient understanding, responsiveness and compassion and ultimately helps your patients feel more comfortable to give fuller histories. And mostly, it relies on your listening skills to comprehend, without judgment, your patients’ story and psychosocial aspects relevant to their health.
If you practice empathy effectively you can facilitate trust and disclosure with your patients, which can be directly therapeutic.
Awareness of cultural barriers
An important aspect of communication with patients is to be mindful of any cultural and religious values.
Being aware of language and cultural communication issues, such as asking permission first before physically examining patients, can make patients feel respected and comfortable. If you’re discussing treatment options with patients who speak a different language, ask your patients if they have understood or arrange for an interpreter to be present during the patient consultation.
It’s important you encourage open communication about treatment preferences, so patients can make decisions for ongoing management that fit within each patient’s unique cultural context.
 Levinson, W. et al. Physician-patient communication JAMA 1997; 277(7):553-9
 Shapiro, R.S. et al. A survey of sued and nonsued physicians and suing patients Arch Intern Med 1989; 149: 2190-6
 Claramita, M et al Doctor-patient communication in Southeast Asia: a different culture? Adv Health Sci Educ Theory Pract. 2013; 18(1): 15-31
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