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Chapter 13: Health Communication   Putting the Patient Back into Physician-Patient Interactions
Health Communication   The process by which one person stimulates meaning in the mind(s) of another person (or persons) through verbal, nonverbal, and mediated messages specifically related to the physical and psychological wellbeing of another person (or persons).
Types of Health Communication
Basic Model of Health Communication   Physican Patient
The Receiver in Health Communication
Types of Patient Communication ,[object Object],[object Object],[object Object]
Verbal Communication   What a patient actually tells her or his physician.
[object Object],[object Object],Nonverbal Communication
[object Object],[object Object],[object Object],Mediated Communication
Health Locus of Control  Page 402 in the Book
Interpreting Your Score Scores should be between 16 and 80. Participants who score above 48 have an internal locus of control.  Participants below 48 have an external locus of control.
Internal LOC   People who have an internal health locus of control believe that the state of their health is largely impacted by their own behaviors.
External LOC   People who have an external health locus of control believe that fate, not personal choices, causes them to be unhealthy.
BIG IDEA   For effective health communication to occur, patients must take responsibility and control of the medical interview.
Utilizing the Patient Information Sheet (p. 289)
Information Your Physician Needs
Actual Reason for Coming (ARC)   Why have you decided to come see a physician?
Physical Symptoms   Physical symptoms refer to any symptoms that can either be felt by the patient or easily seen by both the patient and physician.
Psychological Symptoms   Any change in mood, emotional stability, or thought process that is not explained by normal daily living.
List of Current Medication   Any medication that you are taking (both prescription and over the counter).
Alternative Forms of Medication and Therapy  For example:  osteopathy, chiropracty, Chinese medicine, acupuncture, magnet therapy, cranial therapy, vitamins, muscle enhancers, yoga, etc…
Information to Take Away from Your Physician
Tests & Procedures Conducted ,[object Object],[object Object]
Diagnosis & Prognosis   Diagnosis –  What is Wrong with you. Prognosis –  What your physician thinks will happen next.
Medication &/or Treatment Prescribed What does your physician want you to take (and how)?  What does your physician want you to do?
Side Effects What kinds of things should you look out for as warning signs that the medication/treatment is causing damage?
How Long Should I Wait? Different medications and treatments take different amounts of time to work.  You need to know how long to wait.
Date and Time of Next Appointment
Five Key Points for Patients in the Medical Interview
If you don’t understand your physician, ASK!!!
Don’t hide any details from your Physician.
Own your appointment, you’ve paid for it.
Always get a copy of test results and procedure notes for your own records.
Take Control of Your Health!!!  
Physician Credibility
Growth in Medical Research In 2002 alone, there were 522,943 articles published in some 4,600 medical journals catalogued by PubMed. There is an abundance of medical research being conducted!
The Bad
1999-2003 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
That’s a total of 2,126,955 Articles in just 5 years
According to the PubMed Website 1 , they have over 12 million citations dating back to the 1960s. So the last five years accounts for 18% of all of those citations.
To stay up-to-date with the current medical literature, you would have to read about 6,000 research articles a day.
How many minutes did you spend last week reading about your patients? 2 Stage of Career Range of median reading times % who reported NO reading in the last week Medical students 60-120 min 0% House officers 0-20 min up to 75% Senior house officers 10-30 min up to 15% Attendings 10-90 min up to 40% Senior Attendings 10-45 min up to 15% Consultants graduating since 1975 15-60 min up to 30% Consultants graduating pre-1975 10-45 min up to 40%
Medical Knowledge with Years Since Graduation 3
Patient Satisfaction & Perceived Quality of Medical Care Pages 399 & 400 in the Textbook
Fear of Physician (p. 401) ,[object Object],[object Object]
Gender & Health Comm ,[object Object],[object Object]
[object Object],[object Object]
Physician Communication
Medical Interview   ,[object Object]
Physician Communication: SOAP and SOAP-ER ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
In two different articles found in the  Journal of the American Medical Association (JAMA)  it was found that physicians with good communication skills had fewer patient complaints and lawsuits (Hickson, Federspiel, Pichert, Miller Gauld-Jaeger, & Bost, 2002; Levinson, Roter, Mullooly, Dull, & Frankel, 1997).
Some Research Findings on Physician Communication
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Patient-Physician Communication

  • 1. Chapter 13: Health Communication Putting the Patient Back into Physician-Patient Interactions
  • 2. Health Communication The process by which one person stimulates meaning in the mind(s) of another person (or persons) through verbal, nonverbal, and mediated messages specifically related to the physical and psychological wellbeing of another person (or persons).
  • 3. Types of Health Communication
  • 4. Basic Model of Health Communication Physican Patient
  • 5. The Receiver in Health Communication
  • 6.
  • 7. Verbal Communication What a patient actually tells her or his physician.
  • 8.
  • 9.
  • 10. Health Locus of Control Page 402 in the Book
  • 11. Interpreting Your Score Scores should be between 16 and 80. Participants who score above 48 have an internal locus of control. Participants below 48 have an external locus of control.
  • 12. Internal LOC People who have an internal health locus of control believe that the state of their health is largely impacted by their own behaviors.
  • 13. External LOC People who have an external health locus of control believe that fate, not personal choices, causes them to be unhealthy.
  • 14. BIG IDEA For effective health communication to occur, patients must take responsibility and control of the medical interview.
  • 15. Utilizing the Patient Information Sheet (p. 289)
  • 17. Actual Reason for Coming (ARC) Why have you decided to come see a physician?
  • 18. Physical Symptoms Physical symptoms refer to any symptoms that can either be felt by the patient or easily seen by both the patient and physician.
  • 19. Psychological Symptoms Any change in mood, emotional stability, or thought process that is not explained by normal daily living.
  • 20. List of Current Medication Any medication that you are taking (both prescription and over the counter).
  • 21. Alternative Forms of Medication and Therapy For example: osteopathy, chiropracty, Chinese medicine, acupuncture, magnet therapy, cranial therapy, vitamins, muscle enhancers, yoga, etc…
  • 22. Information to Take Away from Your Physician
  • 23.
  • 24. Diagnosis & Prognosis Diagnosis – What is Wrong with you. Prognosis – What your physician thinks will happen next.
  • 25. Medication &/or Treatment Prescribed What does your physician want you to take (and how)? What does your physician want you to do?
  • 26. Side Effects What kinds of things should you look out for as warning signs that the medication/treatment is causing damage?
  • 27. How Long Should I Wait? Different medications and treatments take different amounts of time to work. You need to know how long to wait.
  • 28. Date and Time of Next Appointment
  • 29. Five Key Points for Patients in the Medical Interview
  • 30. If you don’t understand your physician, ASK!!!
  • 31. Don’t hide any details from your Physician.
  • 32. Own your appointment, you’ve paid for it.
  • 33. Always get a copy of test results and procedure notes for your own records.
  • 34. Take Control of Your Health!!! 
  • 36. Growth in Medical Research In 2002 alone, there were 522,943 articles published in some 4,600 medical journals catalogued by PubMed. There is an abundance of medical research being conducted!
  • 38.
  • 39. That’s a total of 2,126,955 Articles in just 5 years
  • 40. According to the PubMed Website 1 , they have over 12 million citations dating back to the 1960s. So the last five years accounts for 18% of all of those citations.
  • 41. To stay up-to-date with the current medical literature, you would have to read about 6,000 research articles a day.
  • 42. How many minutes did you spend last week reading about your patients? 2 Stage of Career Range of median reading times % who reported NO reading in the last week Medical students 60-120 min 0% House officers 0-20 min up to 75% Senior house officers 10-30 min up to 15% Attendings 10-90 min up to 40% Senior Attendings 10-45 min up to 15% Consultants graduating since 1975 15-60 min up to 30% Consultants graduating pre-1975 10-45 min up to 40%
  • 43. Medical Knowledge with Years Since Graduation 3
  • 44. Patient Satisfaction & Perceived Quality of Medical Care Pages 399 & 400 in the Textbook
  • 45.
  • 46.
  • 47.
  • 49.
  • 50.
  • 51. In two different articles found in the Journal of the American Medical Association (JAMA) it was found that physicians with good communication skills had fewer patient complaints and lawsuits (Hickson, Federspiel, Pichert, Miller Gauld-Jaeger, & Bost, 2002; Levinson, Roter, Mullooly, Dull, & Frankel, 1997).
  • 52. Some Research Findings on Physician Communication
  • 53.
  • 54.
  • 55.
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  • 57.
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  • 59.
  • 60.