The patient walks slowly and cautiously without knowing whether there are water, stones or traps on the road ahead. The communication between doctors and patients is like a flashlight, which illuminates the road ahead and makes the road of diagnosis and treatment smoother.
The factors affecting the doctor-patient relationship are divided into two categories, objective factors and subjective factors. The former includes social system (such as the national medical insurance and the coverage of the new rural cooperative medical system, which makes it more convenient for patients to see a doctor and spends less money), customs, culture and the development of medicine and science; The latter includes medical ethics quality, technical level and psychological state, among which technical level is the core factor affecting the relationship between doctors and patients, and good medical ethics quality is icing on the cake or offering timely help.
When there are problems between doctors and patients, the expression and skills of medical staff are very important.
Doctor-patient communication has the following principles: maintaining patients' self-esteem and informing them equally; Provide useful advice, not replace decision-making; Communicate in a positive way, give people hope, so that patients' psychological feelings can be alleviated, so as to relax and cooperate with treatment; Involve patients, express their ideas and be understood.
The medical factors of disharmony in communication include: the language is too simple and ignores the patient's feelings; Overreacting to some words of the patient; Inconsistent interpretation of content; A bad mood affects the working state; Exaggerate the curative effect and underestimate the bad prognosis.
Professor Yin gave vivid examples to illustrate several factors. There used to be a national survey-"what doctors say is the last thing patients listen to", and at the top of the list is what doctors often say: "You don't understand if I tell you". The patients interviewed said that it was because they didn't understand that they wanted to talk to doctors and themselves. In this way, some things may be made clearer, and the doctor simplifies it, which leads to contradictions. Professor Yin believes that doctors should try their best to consider the social status and cultural level of patients and explain them in a language that patients can easily understand and understand. In addition, what some patients say is not malicious, but doctors may be unhappy. For example, a patient kept asking the doctor, "Have you cured me of this disease? How is your level? " The doctor replied with a smile: "The therapeutic effect depends on your cooperation. If you cooperate well, the treatment will be good. " . If you believe me, we might as well have a try. If you don't think I can do it, you can think of other ways and find another doctor to treat you. what do you think? "In the face of patients' doubts, the doctor's answer is commendable. Junichi Watanabe, a writer who used to be a doctor, put forward the word "insensitive" and warned doctors not to be too sensitive to patients' words. If they fight back, it will easily lead to communication barriers. In addition, doctors should not exaggerate the curative effect in order to comfort patients, but should choose more appropriate language. For example, the patient asks, "Doctor, can I cure it? "Doctors should choose more neutral and positive words such as' we are trying', and the effect may be better.
According to statistics, about 80% of medical disputes are caused by non-technical problems. In order to prevent medical malpractice from going to court, Professor Yin listed the first five effective methods: explaining apology, correcting mistakes, compensating losses, correcting treatment plans in time, and admitting mistakes. These methods are intertwined. These behaviors must come from the heart, restore the facts, help patients deal with the aftermath, let patients feel concerned, and let patients or their families accept them, instead of commenting on who is right or wrong. The sooner you act and communicate, the less negative impact you will have. Doctors should not take chances and miss the best opportunity to gain patients' understanding. When problems occur, people will have deep reflection, but people also have strong forgetfulness, which may fade after a while. We must always remind ourselves not to make mistakes again.
It is said that Harvard Medical School has investigated that 1 of 25 dissatisfied patients will complain, while 2 1 patients will never come back for treatment. 1 Satisfied patients will tell 3 people about their satisfaction, 1 dissatisfied patients will tell 12 people. The word-of-mouth spread of patients makes doctors face many patients instead of 1.
Professor Yin also mentioned how to shorten the distance between doctors and patients: strengthening health education and narrowing the knowledge gap; Take the initiative to return the rights to patients and share the medical risks. She gave an example. A hospital operated on an old man in his seventies. Although his family has sincerely accepted all the consequences, the medical team considers that the operation is risky, and once an accident occurs, his family may still not accept it. As a result, this hospital started the "lawyer witness procedure" to refine the possible risks of surgery to a certain point and a certain point, so that the family members of patients have a deep understanding of the risks of surgery, thus reaching a tacit understanding with the medical team. Of course, in the end, the operation was very successful and reached a perfect ending. However, Professor Yin also mentioned that the signing of the agreement does not mean "exemption", and doctors still have to bear corresponding responsibilities when unexpected adverse events occur during the operation.
According to the characteristics of patients, accumulate experience and be good at communication; In the face of patients' doubts, we should be open and honest and gain recognition; In the face of problems, we should admit them frankly and propose solutions. A competent doctor does not mean that there are no problems, but that he can predict the occurrence of problems and know how to solve them.
Sometimes, the occurrence of medical disputes is not the incompetence of doctors, but the limitations and helplessness of medical development. Only by being honest with patients can we gain understanding. From the doctor's point of view, it is only observation, but it is the patient himself who really feels the pain. Only through doctor-patient interaction can we feel more deeply with patients. Doctor-patient communication is a special form of interpersonal communication and the basis of harmonious doctor-patient relationship. As a doctor, it is very important to comfort the patient's psychology.