APMA News - October 2012 - (Page 54)

Small Business 101 From the American Academy of Podiatric Practice Management, the voice of practice management for the profession. By John Guiliana, DPM Helping Patients Understand Have you ever wondered why we call it “practicing” medicine? It’s because none of us, author included, ever gets it 100-percent right all the time. Medicine is an imperfect art and science. To get as close to 100-percent right as you can, you must transform from a doctor to a “caregiver.” What’s the difference between a doctor and a caregiver? Caregivers encourage their patients to do what’s best for them. In a single word, they get them to “comply.” Caregivers help their patients make the right choice, at the right time, and for the right reason. As physicians, we often become frustrated with non-adherent patients. Non-adherence is estimated to cost our nation’s health-care system more than $100 billion annually. Yet the blame for most non-adherence can be placed squarely on the shoulders of doctors. procedures, they often receive a piece of paper and an instruction to “make an appointment.” Realize how our lack of attention to clinician–patient communication can trigger a malpractice lawsuit:1 Patient feels the explanation of his or her diagnosis is inadequate Patient feels the explanation of his or her treatment is inadequate Patient feels ignored Clinician fails to understand perspective of patient or relatives Clinician discounts or devalues views of patient or relatives Patient feels rushed • • • • • • Listen carefully to your patients. You should not only hear their words, but you should try to hear the emotions their words carry. Capturing these emotions is the essence of empathy. Having years of accumulated knowledge stored in your head is worthless if you can’t persuade patients to do what’s in their best interest. The art of persuasion is a critical component of the art of medicine, yet too many doctors fail at it. If a patient does not agree with a doctor’s recommendation, the doctor will often assume a take-it-or-leave-it attitude, which can mar the relationship between the two. As a result, patients may go elsewhere for their medical care. Be careful not to confuse persuasion with manipulation. Persuasion involves getting someone to do what’s best for him or her, while manipulation yields an outcome that is in the doctor’s best interest. Listen carefully to your patients. You should not only hear their words, but you should try to hear the emotions their words carry. Capturing these emotions is the essence of empathy. Being able to reflect the patient’s emotion back to him or her in the form of paraphrases is the first building block of the powerful bridge of credibility and trustworthiness needed for persuasion. Speaking (imparting information) is easy. Listening is not. The average doctor interrupts a patient after 16 seconds when asking the patient about his or her concerns. Is it any wonder that bridges of trust and bonding are thwarted when our listening skills are so deficient? When patients are sent for lab work and imaging studies, or referred to other clinicians for consultations, treatments, or 54 APMA News October 2012 The following eight steps will help you improve interpersonal communication with your patients: 1. Slow down. Speak slowly and use empathic paraphrases. 2. Use layman’s terms, but be decisive. Explain things to patients like you would explain them to your grandmother. Avoid ambivalence. Use “power phrases” such as “it’s important,” “it’s critical,” etc. 3. Show or draw pictures. 4. Limit the amount of information provided—and repeat it. 5. Use the “teach-back” technique. Confirm that patients understand by asking them to repeat back your instructions. 6. Provide written instructions and literature on the condition as well as the proposed treatment. 7. Adequately train and educate your staff to communicate with patients. 8. Designate a staff member to call the patient to conﬁrm his or her adherence to critical orders. Patients have a lot on their minds while visiting a medical office. If you have a structured system in place to communicate effectively, you will help improve your patients’ understanding of their role and participation in their health-care treatment plan. n Contact Dr. Guiliana at Jguiliana@aappm.org. 1 Sources: (a) Vincent C, Young M, Phillips A. Why do people sue doctors? a study of patients and relatives taking legal action. Lancet. 1994; 343:1609-1613; (b) Hickson GB, Clayton EW, Githena PB, Sloan FA. Factors that prompted families to file medical malpractice claims following perinatal injuries. JAMA. 1992; 267:1359-1363; (c) Hickson GB, Clayton EW, EntmanSS, et al. Obstetricians’ prior malpractice experience and patients’ satisfaction with care. JAMA. 1994; 272:1583-1587.

Table of Contents for the Digital Edition of APMA News - October 2012

APMA News - October 2012
President’s Message
Contents
The National Celebrates 100 Years Advancing Podiatric Medicine
Annual Scientific Meeting Sponsors
Annual Scientific Meeting Registration Form
National Residency Facilitation Project: How Are We Doing?
In Memoriam: Irvin O. Kanat, DPM
ICD-10-CM Effective Date is October 1, 2014
REdRC Subscription Fee Waived for 2012–2013 Residency Year
2012 Podiatric Practice Survey: Benefi ts Received by Respondents
APMA By the Decade: 1992–2001
Reimbursement
Federal Advocacy Forum
List of Cosponsors to the Equity and Access for Podiatric Physicians Under Medicaid Act
APMAPAC Chair Report
IT Consultant
Website Wisdom
Small Business 101
APMA All Stars
In Short
Resolutions Deadlines
Worthy of Note
Affiliates Corner
CPME Invitation for Comments
List of Affiliated Organizations
Insurance Advisor
Member Affinity Programs
New Members
Death Notices
APMAPAC Update
Development Update
Classified Advertising
Dates to Remember
Advertising Index
10 Questions
Your APMA

APMA News - October 2012