In nonurgent situations, positive remarks about nonmedical issues, such as the weather, generalities about the day, or nonspecific encouraging observations, can help build rapport.Īvoid starting with “How are you feeling?” or “How are you today?” because these questions may lead the patient to somatize his or her concerns into physical symptoms. Table 1 outlines a sequence for medical interviewing that incorporates patient-centered elements.Īll persons present at the visit should be introduced. 4 This article provides an overview of patient-centered communication techniques for physicians. disease-focused) based on the patient's age, sex, or ethnicity. 1 Although most patients (about 70%) prefer patient-centered communication, it is difficult to predict preferences for an interviewing style (patient-centered vs.

3 In contrast to a disease-focused biomedical approach, patient-centered care considers patient preferences, needs, and values, ensuring that they guide all medical decisions in tandem with scientific evidence. Patient-centered care builds on discussions and decisions that involve shared information, compassionate and empowering care provision, sensitivity to patient needs, and relationship building. 1 A patient-centered approach to care is based on three goals 1 – 3: eliciting the patient's perspective on the illness, understanding the patient's psychosocial context, and reaching shared treatment goals based on the patient's values. The Institute of Medicine identified patient-centered care as one of six elements of high-quality health care. Training programs on patient-centered communication for health care professionals can improve communication skills. Instead of overwhelming the patient with medical information, small chunks of data should be provided using repeated cycles of the “ask-tell-ask” approach. Shared decision making empowers patients by inviting them to consider the pros and cons of different treatment options, including no treatment.

After disclosing a diagnosis, physicians should explore the patient's emotional response. Before revealing a new diagnosis, the patient's prior knowledge and preferences for the depth of information desired should be assessed. Empathy can be expressed by naming the feeling communicating understanding, respect, and support and exploring the patient's illness experience and emotions. Understanding the patient's perspective entails exploring the patient's feelings, ideas, concerns, and experience regarding the impact of the illness, as well as what the patient expects from the physician. Understanding the patient's perspective of the illness and expressing empathy are key features of patient-centered communication. Communication skills needed for patient-centered care include eliciting the patient's agenda with open-ended questions, especially early on not interrupting the patient and engaging in focused active listening.

Methods of empathetic listening