SKILLS FOR SUCCESS
May/June 2005
The New Frontier: The Doctor-Patient Encounter
Charlene Prounis
Co-President, Flashpoint Medica
A doctor is finishing a consultation with a patient: “You still have elevated hypertension even though you are taking one drug already. Take this medication as well and come back in two months for a checkup,” the doctor tells his patient. He scribbles out the name of the medication on a notepaper and hands it to the patient. The patient hesitates and is about to speak but sees the doctor has his hand on the doorknob.
Walking toward the door, the patient says, “Excuse me, doctor?” her voice, almost inaudible. Distracted, the doctor asks, “Do you need something else?” “No,” she says quickly and leaves, defeated and frustrated.
What went wrong here?
● The patient did not have an opportunity to ask the questions that concern her most: What does this mean, do I have a serious health problem? What should the number be? How long will I have to take this extra drug for?
● The doctor and the patient did not come to a mutual agreement.
● The doctor did not display empathy either verbally or with body language.
● Because she has not received adequate advice, the patient decides to “try the medication for a couple of weeks to see what happens.” What happens is noncompliance and therapeutic failure.
The Doctor-Patient Encounter
The Doctor-Patient-Encounter (DPESM) is the new frontier - a major opportunity for marketers to help doctors and patients communicate better for improved compliance and adherence by creating communications programs that target both doctor and patient
Direct-to-Consumer (DTC) and Direct- to-Patient (DTP) marketing efforts can only do so much. DTC drives patients to request specific medications or bring up medical conditions with their doctors, and DTP targets patients in their home often via the web with education and follow-up materials. However, the crucial moment occurs when the patient and doctor are interacting. In fact, researchers have found that the single best predictor of medication compliance is a patient’s perception of the physician’s interest in him or her as a person. Called “the therapeutic alliance,” one study found that 74% of patients with poor therapeutic alliances failed to comply fully with their medication regimens while only 26% of patients with a good therapeutic alliance with their doctors were noncompliant.
Since the early 1990’s, researchers have been building a robust body of evidence about the effect of doctor-patient communication on health outcomes. Part of this research has focused on specific techniques that enhance DPE.
Strategies for Enhancing the DPE Both patients and doctors play important roles in the DPE process. Patients need to be better prepared for their visit. This process begins with putting them into the right mindset; making them more comfortable talking with their doctors and making them aware of what questions to ask to begin a meaningful dialogue.
The waiting room is the ideal setting to prepare for their DPE, especially if there is material that can help them raise important questions and discuss their therapeutic options. Doctors, on the other hand, need to learn new communication styles and how to inject greater empathy, along with expressions of concern and good will.
Empathy and reciprocity are key components of each communication element. For example, “building a relationship” involves using words that show concern and making eye contact. “Opening the discussion” means allowing patients to complete their opening statements without interruption. Physicians may consider beginning their visits with a patient’s narrative by asking open-ended questions. There are plenty more of these types of “tips” to help make the encounter stronger.
The Role of Marketers
Besides understanding the complex dynamics of the DPE and being able to distill research-based principles into educational and evaluative programs, marketers need to understand what it takes to get patients in the right mindset. And of course, literacy, language proficiency, and culture must be taken into consideration.
For example, a DPE-specific marketing tools could be a waiting room booklet, “What to Ask the Doctor.” Serving as a patient guide for the office visit, this resource serves several purposes:
1. A timely, immediate reminder for questions patients may already have
2. It reinforces the importance of asking questions and clarifying facts.
3. If translated into different languages - with accompanying English translation - it can facilitate communication and enhance overall comprehension, whether or not the doctor speaks the second language.
In the final analysis, marketers who understand the dynamics of can create can strengthen brand value, enhance adherence, and encourage patients to make healthier decisions.