医生和患者之间如何有效沟通（英文）

What is effective communication between doctors and patients?

It should be admitted that the establishment of effective communication is essential and meaningful not only between doctors and patients but also between all individuals. However, this issue between doctors and patients have been heavily underlined these days as more challenges than ever emerged in today’s healthcare environment which caused by a breakdown in communication. According to recent literature and my personal understanding, effective communication consists of doctors and patients who are both good communicators.

How can doctors be good communicators? Patients are suffered severely from their illnesses when they come to hospital, so it is important to comfort them physically and psychologically. It is presented in a paper that doctors have to listen carefully to the needs of their patients and share information in an appropriate way, tailored to the abilities of their patients, to reach satisfying outcomes [1]. The key points are attentive listening and clear and understandable explaining. From my individual experience, doctor who explains tests and test results as well as answers questions honestly, open and in a language I can understand is able to relieve my anxiety in some extent. A research conducted in patients experienced injuries attributed to error and received compensation demonstrates that satisfaction was highest when communications are empathetic and nonadversarial, including compensation negotiations. Patients and families express a strong need to be heard and expected the attending physician to listen without interrupting during conversations about the event [2]. But the truth is that we hardly see doctors spend much time listen to their patients and give their responses to patients’ puzzles which may be attributed to their limited time, suggested about 10 and 15 minutes per appointment in Britain and Portland respectively [3-4].

Besides, how can patients be good communicators? The very first thing is that calm yourself down before communication. Once a patient and his/her family members are controlled by their bad emotion, they will easily have misunderstanding of the doctors’ words, make unreasonable demands or even do something horrible. Secondly, listen to your doctors carefully and provide authentic information about your condition. If possible, patient should prepare questions ahead of appointments considering so little appointment time. In this way, they can provide you with an accurate diagnosis along with methods and cautions of treatment. Thirdly, when any adverse effect occurred, seek help from your doctors right away. Recent days, several events concerning workplace violence against doctors in China have received substantial media coverage. It is investigated that violence against physicians occurred at a rate of 10.1 per 1000 workers in the United States from 1993 to 2001[5]. Focus on these events of workplace violence against doctors, patients and their family who refuse to have effective communication with their doctors should be responsible for these.Modern medicine is neither cheap nor 100 % effective in curing the disease in all cases. There should not be under-expectation on the outcome of the treatment in a serious case [6]. But some patients and their relatives will never understand until they come to the doctors’ office and consult them about the situation.

In summary, effective communication should be built between doctors and patients with preferable communication skills. Only when doctors have a sense of humanities concern and patients have a willingness to trust and respect their doctors, a successful communication can be reached.

References:

[1] Steiner-Hofbauer V, Schrank B, Holzinger A. What is a good doctor?. Was ist ein guter Arzt?/Was ist eine gute Ärztin?. Wien Med Wochenschr. 2018;168(15-16):398–405. doi:10.1007/s10354-017-0597-8

[2] Moore J, Bismark M, Mello MM. Patients' Experiences With Communication-and-Resolution Programs After Medical Injury. JAMA Intern Med. 2017;177(11):1595–1603. doi:10.1001/jamainternmed.2017.4002.

[3] Flaxman P. The 10-minute appointment. Br J Gen Pract. 2015;65(640):573–574. doi:10.3399/bjgp15X687313.

[4] Goldstein IH, Hribar MR, Read-Brown S, Chiang MF. Association of the Presence of Trainees With Outpatient Appointment Times in an Ophthalmology Clinic. JAMA Ophthalmol. 2018;136(1):20–26. doi:10.1001/jamaophthalmol.2017.4816.

[5] Phillips, J. P. (2016). Workplace violence against health care workers in the united states. The New England Journal of Medicine, 374(17), 1661-1669. doi:http://dx.doi.org/10.1056/NEJMra1501998.

[6] Ghosh K. Violence against doctors: A wake-up call. Indian J Med Res. 2018;148(2):130–133. doi:10.4103/ijmr.IJMR_1299_17.