Basic principles of doctor-patient communication

Lead: The reason why the learning of doctor-patient communication knowledge and skills needs to run through the whole process of medical education and be implemented in medical service practice is because the doctor-patient communication level of doctors is directly and indirectly related to medical quality, efficiency and benefit, and affects the construction of social spiritual civilization and material civilization. The basic principles of doctor-patient communication are welcome for your reference!

Basic principles of doctor-patient communication 1 (1) Basic principles of doctor-patient communication

In doctor-patient communication, the language and behavior chosen to achieve the ideal state must follow the following nine basic principles of doctor-patient communication:

First, people-oriented The development of modern society takes people as the core, and the value orientation is to meet people's needs. People's demand for medical care has changed from a simple physiological demand to a comprehensive physiological, psychological and social demand. People not only need excellent medical technical services, but also need psychological care and respect. Therefore, the people-oriented concept conforms to the transformation of modern medical model. As far as possible to meet the needs of patients, to give patients more humanistic care, so that patients are satisfied, so as to achieve the goal of patient-centered.

Second, the principle of good faith. Honesty is the cornerstone of a society's survival and development, and it is also the foundation and foundation of doctor-patient communication. In other words, only honesty can establish a good doctor-patient relationship. To do this, doctors and patients should trust each other first. Especially as medical personnel, we should pay special attention to win the trust of patients. Because this determines whether the patient can cooperate with the medical staff well. As patients, we should also trust doctors, which is not only the respect for doctors, but also the need to ensure the therapeutic effect. Second, be responsible for each other. Patients should share the responsibility of treating diseases with doctors.

Third, the principle of equality. Both doctors and patients are equal, which is the premise of good communication. The traditional doctor-patient relationship is dominated by doctors, and doctors always have a sense of superiority towards patients, which is one of the important reasons that affect the good doctor-patient relationship. Practice has proved that with the transformation of medical model from simple biological model to biological, psychological and social model, equal and cooperative relationship will increasingly reflect the development trend of new doctor-patient relationship.

Fourth, the general principle. With the fierce social competition, the pace of people's work, study and life is accelerating, and the tension is getting higher and higher. People's psychological barriers and other issues are increasingly prominent. Clinically, we can often feel that there are more and more psychological factors involved in various diseases. Therefore, doctors should consider not only biological factors, but also psychological and social factors of patients when making basic diagnosis and treatment. It is necessary to communicate from the overall level and fully understand the patient's situation, so as to provide more comprehensive and holistic medical services.

Fifth, the principle of sympathy. Whether medical staff are sympathetic to patients is the key to whether patients are willing to communicate with medical staff. Patients always think that their pain is outstanding and hope to get the sympathy of medical staff. However, due to professional reasons, medical staff are commonplace and easy to show indifference. The best way to solve this problem is that medical staff must sympathize with patients. Only in this way can we communicate effectively with patients.

Sixth, the principle of confidentiality. In the whole process of diagnosis and treatment, especially in the process of medical history collection, patients' privacy is often involved. There may be many things that patients don't want others to know. We medical staff have the responsibility to meet the needs of patients, and we can't reveal the privacy of patients casually, nor can we make fun of or discriminate against patients. Once our volunteers show contempt and disdain for patients' privacy, it will seriously damage patients' self-esteem and affect further communication between doctors and patients.

Seventh, the feedback principle. The dialogue between patients and doctors is a two-way communication process. Medical staff should give their own information back to the patients in time, and they can check the patients' understanding by eye contact and simple questions, so that the conversation will always be harmonious and will not be deadlocked.

Eighth, participation principle. The whole diagnosis and treatment process needs full participation and good communication between doctors and patients. Medical staff should listen to patients' opinions patiently and let patients participate in decision-making. You can judge the problem by asking the patient's condition, and explain and inform the patient of the diagnosis and treatment plan. Patients who are not clear about the diagnosis and treatment plan proposed by the doctor or have different opinions can communicate with the doctor. In addition, doctors should maintain good communication with patients' families, understand patients' family and living conditions, find out the causes comprehensively and accurately for medical staff, and formulate targeted and feasible treatment measures, which is of great value. We can also design various treatment schemes according to the patients' diseases, family conditions and socio-economic conditions, and introduce them to patients and their families in an all-round way, so that they can actively participate in the choice of treatment schemes.

Ninth, the verbal communication of medical staff is also very important. Hippocrates once said: "Doctors have three magic weapons: language, medicine and scalpel. The doctor's language is like his scalpel, which can save people and hurt people. " The Fukuoka Declaration states: "All doctors must learn communication and interpersonal skills. Lack of compassion should be as incompetent as lack of technology. " Therefore, in clinical practice, it is not enough for doctors to only have theoretical knowledge, but also to strengthen the cultivation of practical ability of language communication.

Basic Principles of Doctor-patient Communication Part II Language communication skills of medical staff are as follows:

1. Language that medical staff should be proficient in.

You should use more comforting language. For example, for some patients with great pain and mental stress, medical staff should comfort them that "don't be sad, your illness can be alleviated after treatment" or "it can be improved" and "it can be cured". Patients who encounter some examinations are nervous and uncooperative, so we should comfort him "Don't be nervous and relax, this kind of treatment or examination is basically safe". The most taboo language in clinic is reprimanding patients. For example, "don't move, just bear it." How can there be painless treatment? Why are you so delicate? " Or "Why are you so wordy? What are you going to say? Why can't you explain your illness clearly? " "I have explained clearly enough. Why don't you know? " These reprimands can only make the mood of seriously ill patients worse.

Use encouraging language. When communicating with patients, try to please them and use encouraging language. In order to stabilize patients' mood, we can also use some white lies to establish patients' confidence in overcoming the disease. Clinically, the most taboo is to use some negative hurtful language. For example: "You are ill, and the result is already very good", or "It is meaningless to cure your illness, so you can eat whatever you want when you go back". Such language will cause direct harm to patients.

Some convincing language should be used. For some patients who are impatient with treatment and make endless suggestions, we should persuade them: "Don't worry, please rest assured, we will carefully study your condition and formulate a plan suitable for you. After treatment, you will get well soon. " For such patients, reprimanding language cannot be used. For example, "you are a doctor or I am a doctor, who listens to whom", or "you have seen so many hospitals, but you are not optimistic. How can you come at once? I'm not a fairy ",or" why don't you insist on taking medicine, and you are responsible for what goes wrong ". Such language will do harm to the patient's body and mind.

Instruction language. Mandatory language refers to asking patients to cooperate in order to meet the needs of treatment or examination. For example, clinically, we often hear something like "Tomorrow, we have arranged a physical examination for you, so you can't have breakfast tomorrow, so please prepare on an empty stomach" or "You must take medicine as required when you go back. In the process, if your condition changes, you can come to see a doctor at any time". The most taboo language in clinic is: "Listen clearly and do as required, otherwise you will be responsible for the problems". The same is true for some tests. If the mandatory language is not used well, it will become a reprimanding language. For example, the same examining doctor said, "Please lie on the bed and take off your clothes, and I will examine you", while another tone said, "Go, lie on the examining bed, move quickly and take off your clothes". Comparing the two languages, different tones can reflect different attitudes towards patients, which will inevitably produce different feelings in patients' hearts and directly affect the harmony between doctors and patients.

These are four languages that should be skillfully used in clinical work. In practice, we can also feel the appropriate language expression of medical staff, which not only makes patients actively cooperate with treatment and recover as soon as possible, but also helps to enhance patients' confidence in overcoming diseases and give them hope and strength. This not only reduces the disputes between doctors and patients, but also promotes the harmony between doctors and patients.

2. The principle of medical staff addressing patients

(1) According to the patient's identity, occupation, age and other specific circumstances, it varies from person to person and strives to be accurate. For example, if the patient is a teacher, we should call him a teacher; The patient is a worker and should call a teacher; The patient is an elderly person,

In outpatient and inpatient wards, it is necessary to set up a clear process for selecting doctors for patients and a column for introducing doctors in various departments. Patients can choose freely. When there are difficulties, outpatient doctors or ward nurses can help patients choose doctors according to their specific conditions.

(2) Establish a price adjustment mechanism. Publicize the price differences of doctors in different levels of hospitals and different occupations in registration fees and medical treatment fees, and better reflect the labor value of medical technology level. This will allow patients to choose different levels of doctors according to their illness and their own economic situation, which is also conducive to the rational use of medical resources, and also enhances the sense of responsibility and enthusiasm of doctors.

(3) Introducing competition mechanism. The frequency of patients choosing doctors, including the number of registered doctors, the number of operations, workload, etc. It also reflects the doctor's medical skills and medical ethics to a certain extent. Therefore, hospitals should implement the reform of distribution system related to the quality and quantity of doctors' work, so that doctors' income can be linked to their work performance. This measure is also an important link to ensure that patients choose doctors without becoming a mere formality.

Second, special needs services. In order to meet the needs of different levels of health services, it is becoming more and more important for hospitals to provide special services for patients. Usually, the outpatient service is to arrange the whole medical guidance service from the beginning of the patient's visit, to assist the patient in pricing, taking medicine and settlement, to accompany the patient to various auxiliary departments for examination and diagnosis, and to contact experts in various departments for consultation. Let the patient feel that the doctor is always by his side. Ward implementation has two main aspects:

(1) star hotel ward. The environment is elegant and comfortable, which is very suitable for patients to practice.

(2) Establish a family ward. The design of the ward reflects the atmosphere of home.

Third, the outpatient and emergency medical guidance system. There are generally three forms:

(1) Medical guidance and consultation of medical staff. This is the main form of guiding doctors.

(2) Introduction of hospital blackboard newspaper.

(3) Multimedia medical guidance. Publicity and introduction to the public, such as experts, equipment and instruments, medical level, scientific research ability, charging standards for various drugs and medical materials, etc. The purpose of the above three kinds of medical guidance, no matter what form, is to let patients know the process of medical treatment, the place to go and the preparations for various examinations conveniently, simply and quickly, so as to reduce the hospitalization time of patients.

Fourth, medical expenses are made public. There are three specific measures:

(1) Strictly implement the price policy and publicize the main contents of charges. The hospital shall announce the items and prices of medical charges in wards, pharmacies, discharge places and other places, and implement the price tag clearly.

(two) the implementation of hospitalization expenses list system. Let patients understand money and illness.

(3) Communicate with patients in time. For some expensive tests, the patient's consent should be obtained in advance; For patients with medical expenses overruns, it is necessary to communicate and discuss with their families in time. If the patient is really unable to pay, we should try our best to maintain the basic medical expenses of the patient and insist on the patient first.

First, the principle of life first.

The above four forms are not only the reform and exploration of medical institutions in mechanism formulation, but also conform to the changes of modern medical model, reflecting the value orientation of taking patients as the center and meeting the needs of people at different levels for health services. In particular, the disclosure of medical expenses reflects the hospital's honest and transparent service, which can win the trust of the public and patients and reduce disputes between doctors and patients.

At present, what are the explorations of medical institutions in mechanism formulation?

Thirdly, the environment and technology of doctor-patient communication.

With the continuous development of China's national economy and the improvement of people's living standards, the requirements for the internal and external environment, comfort and diet of hospitals are getting higher and higher. Optimizing and building the internal and external environment and improving the level of medical technology are not only the requirements of modern medical model, but also the needs of doctor-patient communication.

The main contents of hospital's environmental and technical optimization are:

(1) hospital physical environment optimization. Including a clean ward, a quiet, comfortable and beautiful environment, good ventilation, plenty of sunshine and a sense of security.

(2) Optimization of hospital management and culture. It mainly includes system construction, spiritual construction and image construction.

(3) Optimization of medical technology. This is the most important guarantee of hospital image. Because the technology of the hospital is the embodiment of the comprehensive strength of the hospital and the basis for establishing a good doctor-patient relationship. The core of medical technology optimization is innovation. Technological innovation and technological progress are the means and technical guarantee of innovation. The patient's trust in the doctor is largely the recognition and trust of the doctor's professional and technical level, which is also the premise of doctor-patient communication.

What is the main content of hospital environment and technology optimization construction?

Fourth, the communication between doctors and society and news media.

If medical institutions want to have a good external public opinion atmosphere, they must actively communicate with the news media and maintain an effective way to communicate with the news media.

There are two main ways for doctors to communicate with social news media:

(1) Actively strengthen contact with journalists. Medical institutions should establish a ray contact mechanism with reporters on the news media hotline, and communicate with reporters on the hotline regularly and irregularly, so as to let them know about the hospital process, the difficulties of doctors, the high risk of medical treatment and the development of the hospital.

(2) Keep in touch with the news propaganda management department. Leaders and journalists of medical institutions should establish contact with the departments in charge of news propaganda in their respective regions. Let them know the overall situation of the hospital, which is also an important way to keep the hospital publicized. The news media should also maintain stability and promote harmony, adhere to positive guidance and carry forward the main theme, adhere to comprehensive, objective, fair and scientific news reports, and put an end to exaggeration, speculation and false reports. All parties will work together to create a good public opinion atmosphere in which the whole society respects science, life and the legitimate rights and interests of both doctors and patients, and promote mutual understanding between doctors and patients.

Expansion: the skill of doctor-patient communication

1, fully respect the patient in your heart.

All men are born equal, and medical staff should first respect the personality of each patient and the life of the patient. In addition, we should also respect patients' understanding and diagnosis and treatment of diseases. Even if this understanding is wrong and one-sided, we should not force patients to change it. Instead, we should guide, explain and suggest at an appropriate time, give patients some time to think and finally make the right choice.

2, patiently listen to the patient's complaints

The patient is the person who knows his illness best. The patient's talk is an important means for doctors to collect information about their illness, and whether the information collection is comprehensive and accurate is directly related to the diagnosis and treatment effect. A doctor who can't listen patiently to patients' complaints can't grasp patients' information, and its curative effect is hard to say.

3. Pay attention to patients' medical expenses.

Doctors should not only grasp the changes of patients' condition, but also pay close attention to the medical expenses that patients may bear and consider the actual economic affordability of patients. "Overtreatment" violates clinical medical norms and ethical standards, can not really improve the value of diagnosis and treatment for patients, but will only increase the consumption of medical resources.

4, objectively and truly reflect the therapeutic effect.

The human body is a very complex system, and human understanding of diseases is still very limited. Up to now, there are still many diseases that are difficult to overcome and lack effective treatment methods. Therefore, doctors should objectively and truly reflect the current treatment status to patients and avoid exaggerating their diagnosis and treatment effects. The so-called "imperial doctor" does not exist.

5, pay attention to the patient's emotional changes.

Many patients suffer from long-term pain and mental problems. Therefore, doctors should pay attention to patients' emotional changes, provide more comfort and guidance, avoid using irritating language, and communicate with family members when necessary to gain understanding and help.

6, the application of easy-to-understand language

Doctors should pay attention to understanding the patient's cultural level and education level, try to avoid using technical terms that patients don't understand, and explain the illness in a popular and vivid way.