When A Patient Speaks

v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.

Spoken language is the most important diagnostic and therapeutic tool in medicine, and, according to Dr. Cassell, "we must be as precise with it as a surgeon with a scalpel." In these two volumes, he analyzes doctor-patient communication and shows how doctors can use language for the maximum benefit of their patients. Throughout, Dr. Cassell stresses that patients are complex, changing, psychological, social and physical beings whose illnesses are well represented by their own communication. He proposes that both listening and speaking are arts that can be learned best when they are based on the way that spoken language functions in medicine. Accordingly, Volume I focuses on the workings of spoken language in the clinical setting. It analyzes such important aspects of speech as paralanguage (non-word phenomenon like pause, pitch, and speech rate), how patients describe themselves and their illnesses, the logic of conversation, and the levels of meanings of words. Volume II is a practical, detailed, how to guide that demonstrates the process of history taking and how the doctor can learn the most from the information that the patient has to offer. His arguments are amply illustrated in both volumes by transcripts of real interactions between patients and their doctors.

For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

Can refocusing conversations between doctors and their patients lead to better health? Despite modern medicine’s infatuation with high-tech gadgetry, the single most powerful diagnostic tool is the doctor-patient conversation, which can uncover the lion’s share of illnesses. However, what patients say and what doctors hear are often two vastly different things. Patients, anxious to convey their symptoms, feel an urgency to “make their case” to their doctors. Doctors, under pressure to be efficient, multitask while patients speak and often miss the key elements. Add in stereotypes, unconscious bias, conflicting agendas, and fear of lawsuits and the risk of misdiagnosis and medical errors multiplies dangerously. Though the gulf between what patients say and what doctors hear is often wide, Dr. Danielle Ofri proves that it doesn’t have to be. Through the powerfully resonant human stories that Dr. Ofri’s writing is renowned for, she explores the high-stakes world of doctor-patient communication that we all must navigate. Reporting on the latest research studies and interviewing scholars, doctors, and patients, Dr. Ofri reveals how better communication can lead to better health for all of us.

Primary care medicine is the new frontier in medicine. Every nation in the world has recognized the necessity to deliver personal and primary care to its people. This includes first-contact care, care based in a posi tive and caring personal relationship, care by a single healthcare pro vider for the majority of the patient's problems, coordination of all care by the patient's personal provider, advocacy for the patient by the pro vider, the provision of preventive care and psychosocial care, as well as care for episodes of acute and chronic illness. These facets of care work most effectively when they are embedded in a coherent integrated approach. The support for primary care derives from several significant trends. First, technologically based care costs have rocketed beyond reason or availability, occurring in the face of exploding populations and diminish ing real resources in many parts of the world, even in the wealthier nations. Simultaneously, the primary care disciplines-general internal medicine and pediatrics and family medicine-have matured significantly.

Patient Speak is a reference guide of communication techniques and approaches recommended for healthcare and medical professionals to use when interacting with their patient and family members. Trust is built through effective conversations with compassion between physicians, nurses and specialists and their patient. Only then do patients and family members feel the genuine concern of their medical team for their overall emotional, psychological, and physical health. The care and connection you have with your patients and their families, providing respect, dignity, and concern for their mental well-being, in addition to their physical needs, can be life changing. Patient Speak helps reinforce effective communication practices that will leave patients with more positive impressions about their time interacting with medical professionals.

This book offers a much-needed introduction to the dynamics of the communication exchange between providers and patients in the health-care environment. Starting from the principle that health-care-providers and patients try to speak the same language to reach the best decisions for patient care, but often misunderstand each other whilst navigating the process of diagnosis, treatment and care, Lisa Sparks and Melinda Villagran clearly explain how health communication theory and research can help us better understand these complex interactions, and provide strategies for improving patient and provider communication. Sparks and Villagran cover a broad range of key issues and theories related to provider-patient interaction, including patient information and affective needs, barriers to effective communication in health-care contexts, and communication skills training for providers. Drawing on the most current literature in this vibrant field, they show the transformations that new technologies such as e-mail and text messaging have brought to communication with and between patients and providers, consider the roles of caregivers, both formal and informal, and illustrate how health-care organizations impact on interpersonal interactions. Throughout the book, Sparks and Villagran deftly illustrate how communicative understandings of patient-provider interaction can have positive practical outcomes, feeding into health behaviour change, creating a communication environment which can improve health literacy and ultimately lead to better health outcomes. With groundbreaking insights, on-point explanations, and deeply moving examples, Patient and Provider Interaction illuminates and enriches what is most often one of the most important interactions of our lives.

Communication skills determine how the world perceives us - and how we perceive the world. Communication is at the heart of who we are and all that we do. As a clinician, your communication impacts how you take care of patients, work with colleagues, teach trainees, and engage audiences and the public. Communication encompasses all aspects of human skills, from listening and clearly articulating thoughts to an awareness of physical gestures, specific word choice, tone, and volume. Whether engaging with patients, peers, care teams, family members, residents, researchers, insurance agencies, management, or journalists, successful communication requires focusing on the importance of the relationship and the mission of each interaction. Today, due to the rise of digital technologies including electronic medical records, online forums, and video conferences, the content of information, the platform, and the audience are continuously changing and expanding for physicians. There is a great need in the physician community to learn how to facilitate the exchange of information, provide psychosocial support, partake in shared-decision making, translate complex information, and resolve controversies with sound science in a variety of settings. Addressing physicians at every level of training and practice, Physician Communication: Connecting with Patients, Peers, and the Public will enable providers to examine, analyse, and improve their skills in the art and science of communication. Divided into four sections: Face-to-face Communications; Digital Communications;Public Speaking; and Traditional Media, this book will help physicians navigate various situations using different methods and modes of communication.