Transcript The Dermatologist-Patient Relationship

The Dermatologist-Patient
Relationship
Matthew H. Kanzler, MD
Clinical Professor
Assoc. Residency Program Director
Stanford University Dept of Dermatology
Chief of Dermatology
Santa Clara Valley Medical Center
Conflict of Interest Statement
• I have no conflicts of interest to report
– I receive no money from any company or
industry for anything
– I am on no speaker bureaus
– I am not a paid consultant
Importance of Office Staff
• The appointment starts with the first phone
call, and ends with the checkout process
• MD-patient interaction is small portion of
overall appointment experience
• Hire personalities, not résumés
• Utilize Medical Assistants!
Efficient Office Flow
• Realistic scheduling templates
• Keep patients informed of delays longer
than 15 minutes
• Acknowledge delays, apologize sincerely,
and proceed with visit
Components of an Efficient
Dermatologist-Patient Relationship
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Rapport Building
Collaborative Agenda Setting
Elicit Patient’s Perspective
Co-Create a Plan
Patient Education
Rapport Building
• Professional appearance
– White coat
– Name badge
– Leave “dress-down” Fridays to Yahoo!
• Warm greeting, handshake
• Brief non-medical interaction
• Constant eye contact
Collaborative Agenda Setting
• Determine number & importance of all of
patient’s problems up-front
– Confirm MA’s intake with patient
– “Anything else?”
– Prioritize
• Confirm with patient expectations of
current visit
Elicit Patient’s Perspective
• Patient’s beliefs and fears
– Knowledge of disease, treatment
– “cancer, contagious, AIDS”
• Family or cultural influences
• Watch for nonverbal clues
• Patient’s ideas for next steps
Co-Creating a Plan
• Patients are more satisfied and have
better outcomes when they are involved in
treatment plan creation
• Adherence to Tx plan dependent on:
– Financial resources
– Social resources
Co-Creating a Plan
• Agree on goals of care, next steps, role of
patient & family members
• Keep plans simple at first
• Allow time for plan adjustment in response
to patient preferences and limitations
Patient Education
• Patients will remember half of what you tell
them
• Utilize MAs to provide education
• Provide written handouts to complement
instructions
• Emphasize preventative measures/
behavioral changes