Physicians Practice - February 2008 - (Page 43)

• Stay connected. Gillick say that “coming across as closing the door” is another common error physicians sometimes commit in the context of delivering bad news. “Giving their patients the idea that ‘this is it; this is done now’ leaves them with a feeling of abandonment,” says Gillick. “They need to feel that there is someone they can trust who can help them through this process.” REALITY CHECK Unfortunately, today’s volume-based practice model is conducive to committing such errors, says Puchalski. “Unless physicians are very lucky, most of them are seeing patients in very brief amounts of time, and that’s getting worse and worse,” she explains. “And you don’t want to open up a can of worms that you don’t have the time to give attention to. If you bring bad news and you have a 15-minute visit, for some people that might be ﬁne, but for others, they may need to talk to you for 45 minutes or an hour. And you can’t schedule that. So what you’re naturally going to do is approach it in such a way that accommodates that 15-minute visit.” READ MORE ABOUT IT! Visit PhysiciansPractice.com for additional information on enhancing physician/patient communication: • Type “bad news” in our Search • Are you listening? Effective Articles box for similar stories on giving patients poor diagnoses. communication skills are essential for a good patient visit. Type “Curing Hearing Impaired MDs” in our Search Articles box. • Are your patients satisfied with their care? Find out by downloading our “Patient Satisfaction Survey” from our Tools section. Puchalski has some suggestions: Offer a very distraught or crying patient some private time while you see your next appointment. “If you have someone who can come and sit with them, or if you have a family member come in, there’s various ways that you can do it,” she says. Periodically check on the patient between other visits, try to meet their current needs as much as possible, and make a plan for following up. Sometimes Puchalski will even give her cell phone number to patients who she feels genuinely need it, telling them to call her if they continue to have a hard time and feel the need to check in. “And I’ve never, ever, ever had it abused by a patient,” Puchalski emphasizes. “Never.” If you’re not comfortable with this level of connection, then have a nurse or other appropriate staffer in your practice give the patient a call the following day. Finally, alert a particularly panicstricken patient of an “off-time” that you’re available, such as a half-hour before clinic hours. Puchalski invites such patients to her clinic at 7:30 a.m., before her ﬁrst 8 a.m. appointment. “It doesn’t matter how you do it,” she says. “The important thing is to let patients know that you are there for them.” But not all bad news visits need be long ones, adds Puchalski. Be “fully present” during such patient encounters, and you’ll ﬁnd you can effectively fulﬁll patients’ emotional needs without falling behind schedule. Studies have indicated that patients who perceive their physicians as being fully present when they receive bad news often think the visit lasted longer than it actually did. But what does this mean, being “fully present?” Buckman’s widely adopted six-point protocol, known by its acronym, SPIKES, explains it well: FEBRUARY 2008 | PHYSICIANS PRACTICE | WWW.PHYSICIANSPRACTICE.COM 43 http://doctordirectory.com http://PhysiciansPractice.com http://www.ddsignup.com http://doctordirectory.com http://WWW.PHYSICIANSPRACTICE.COM

Table of Contents Feed for the Digital Edition of Physicians Practice - February 2008

Physicians Practice - February 2008 Contents The Bigger Picture: Your Future is in Your Hands Letters Physicians Practice Pearls: Creating an A+ Practice Noteworthy Cover Story: Conquering Time: 5 Keys to a More Efficient Practice In Balance: A Family Affair Technology: Making EMRs Work in the Exam Room In Practice: "I've Got Some Bad News" The Tech Doctor - The EMR: Savior or Poseur? Ask the Experts NEW! Healthonomics: How to Handle Health Savings Accounts The Administrator's Desk: Finishing School for New Managers Human Resources: Is Your Partner Impaired The Great Practice Makeover: Too Well-Liked for His Own Good? Coding Idealab: 'Why I Blog' Classifieds Advertiser Index

Physicians Practice - February 2008

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