Developing Better Patient, Physician Relationships

Hospitalist Group, UH PFSAC Team-up to on New Project

 By Beth Konikoff, UH PFSAC Advisor

The University Hospital Patient Family Staff Advisory Committee (UH PFSAC) is excited to announce a new initiative, the Patient and Physician Relationship-Centered Project, which will have its inaugural kick-off in January. In partnership with the UH Hospitalist Group, the PFSAC will be working on developing a two and a half-hour workshop focused on communication and empathy-building skills between physicians and patients. Three hospitalists have agreed to co-lead this project: Dr. Anna Burke, Dr. Anu Goyal, and Dr. Jan Schlaff. This unique workshop has three critical components: Education, Practice, and One-to-One Coaching.

The Hospitalist Group volunteered to partner with the PFCC committee on the pilot because their physicians experience some unique challenges trying to develop a relationship with their patients.

“Many of our patients are only here for two days, plus they located are all over UH,” said Dr. Burke, who treats upwards of 11-12 patients on her primary service. When she has cross cover she can have 2-3 additional teams to cover.  Hospitalists have to quickly familiarize themselves with every kind of illness and injury possible and work in conjunction with specialists of all fields. On one shift last week, Dr. Burke had a patient with a brittle bone disorder, one patient who had sustained a degloving foot injury, and a man who was displaying undiagnosed cognitive issues, plus eight other patients.

During round table discussions facilitated by patient advisors, physicians will have a chance to share and discuss uncomfortable communication experiences that have or can occur with patients and talk about ways to handle tough cases. This may cover situations including: when physicians must deliver life-changing information, an uncomfortable patient or family response to a diagnosis, setting boundaries with a drug-seeking patient, or non-medical care questions for which the physician may feel unprepared.

“The drug-seeking patient can take up so much of your time that it takes away from your other patients,” said Dr. Burke. “We have to say no, the patient gets angry, and nobody teaches you how to deal with that. It affects you globally. It impacts all of your patients.”

One of the objectives of the project will be to identify five key approaches that can lead to better patient-physician relationships and five types of communications to avoid when interacting with a patient. A Research Working Group, led by Patient Advisor Tiffani Stokely, will be reviewing the latest articles and data on patient and physician communication. In addition, nearly 20 health systems across the nation will be interviewed on their best practices in promoting better relationships between patients and physicians.

In another activity, UH PFSAC advisors will create difficult communication scenarios that illustrate how subtleties of communication can lead to positive or negative reactions and relationships between patients and physicians.

Following the workshop, one-to-one coaching will be designed to put the training into action. These PFCC advisor coaching sessions will be held two to three weeks after the workshop. The PFSAC Coaching Team will pair one advisor with each of the participating physicians. Together, the pair will conduct actual patient rounds for one shift. Following these rounds, the physician and advisor will debrief together, reflecting on the relationship-building and communication skills learned from the workshop and demonstrated during rounds. Additional coaching sessions can be added for review and assessment as necessary.

“I have a lot of years I’d like to spend as a hospitalist and I worry about burn-out,said Dr. Burke. “I don’t know of any doctors who don’t care about their patients and, if there’s anything we can do to improve our relationships with our patients, then that will increase our job quality. A little change in tone or in expectation can go a long way.”

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