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Patient-Physician communication addressing a physical exam

Posted Sep 16 2008 6:00am

At the medical office there’s a need of a dialogue.

Dialogue between patient and physician

The dialogue between patient and health care provider should be based on the potential expectations of the patients, the level of knowledge, the individual variables, the respect for the patient time, and a consideration of the power of the patient. The respiratory patient usually bases his or her visit in on the interference with the ventilation of the lungs as well as new symptoms. All this information can be gotten through the appropriate partnership built in a few amount of time. However, it is more than time what defines an adequate approach during the assessment of a respiratory patient. It’s related to straight and high quality communication.

Communication: the big deal

In the construction of a patient-physician relation, the communication needs to overlap several processes to make of them a continuum. Sending is a key element in the messaging of information to a patient. But sending is not an exclusive process, the process of delivering information to a patient requires to expect a feedback, a series of immediate reactions. The reactions of the patient come to the physician in different ways, words, facial expression, gestures, silence. It’s responsibility of the physician to give value to the patient’s reaction and preparing more support. This specific details make of the typical sender a formal receiver, while the patient is a sender.

As always, our major feature as human beings is our main problem most of the times: verbal communication. This indicates a necessity of being constantly careful when talking to the patient or the physician. I my physician clear about what I do feel? Is my patient getting the right message? If no: why?

Fundamentals of diagnosis and treatment

An appropriate diagnosis is pending on precise information and adequate analysis. If a patient gives clear messages, the physician organizes a better approach. If a physician provides with clear definite recommendations and well designed instructions, a patient is put in the right track.

Part of the communicative procedure is also supported by a physical contact integrated to the conversation. It’s more than writing on the laptop while hearing answers to those cold medical questions. A close appropriate contact with the patient during the physical examination is not only the auscultation of the thorax but asking questions and hearing the patient.

Physical exam abridging the path to diagnosis

The physical examination is mostly oriented by the answers to specific questions. Is you mass sensation at the right side? implies a careful examination of the left and later of the right side. Is the pain more intense on the back or in the chest? Imposes a starting at the less painful location. All this to create a parameter for comparison.

Of course, the intention wouldn’t be to tell to the examiner what to do but how to do it. The examiner will make a general evaluation, but this will be followed by a confirmatory process to grade the level of symptoms impact on physical structures.

The indispensable patient voice

One thing is clear: what patient says is key for exact diagnosis and efficacious treatment. Then, in first visits, the physical exam should be a good complete one. The following exams should be directed to the abnormalities informed by the patient during the visit. This does not preclude an exclusion of complete exam if it is performed very infrequently.

Then, it seems to be clear that the skills of a physician need to be put into practice combining the information coming from the patient as well as knowledge and respect. If some of this elements are not working, the decisions are far from being well oriented.

Call to a synchronic action

Patients should prepare their conversation with doctors. Doctors should be prepared to hear patients and share with them the knowledge to improve the results of an office’s visit. This will lead to a smooth process of understanding of the parties programming the cure or the approach to handle the health condition.

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