How to Fuel Engaged Patient Dialogue

In the average 10–15 minutes a rheumatologist has to spend with a patient during a clinic visit, limited time exists for extensive dialogue. Yet, taking the time to delve a little deeper by asking a patient questions in order to understand and address concerns could make a big difference in a patient’s care.

“Too often, a patient may feel [too] intimidated to ask a question to clarify a term we use or may fear embarrassment [and avoid] bringing up a concern that can be related to their condition, such as intimacy issues,” notes Ara Dikranian, MD, a rheumatologist with the Cabrillo Center for Rheumatology in El Cajon, Calif.

Common questions Dr. Dikranian receives from patients address how therapeutic medications may affect them. In addition, information, misinformation or incomplete information a patient may learn from friends or commercials may create concerns that need to be addressed. “Listening to concerns and asking directed questions can make a big difference in establishing a stronger rapport with our patients.”

This rapport can support a stronger connection between the patient and provider that translates to improved care, according to results from a survey of providers and patients. Dr. Dikranian and a global advisory panel of rheumatologists reported the findings in 2016.¹

The study elicited important data about how patients and providers perceive interactions, concerns and treatment goals. Although 90% of provider respondents said they were satisfied with their communications with patients, 61% of surveyed patients said they felt uncomfortable raising concerns or fears with their providers.

“Despite rheumatologists thinking we are doing a good job of communicating with our patients, the fact remains that we have limited time for this interaction, and there is much room for improving meaningful dialogue between patients and providers for shared decision making to help patients achieve collaborative treatment goals,” Dr. Dikranian says.

Here are five lessons based on the study findings Dr. Dikranian is applying with his own patients.

1. Be Quiet & Listen
Giving patients the opportunity to talk allows the focus of the appointment dialogue to shift from the rheumatologist’s agenda to the patient, giving them a chance to voice concerns that may be unrelated to their rheumatic condition. Sometimes, these patient concerns, such as a patient experiencing anxiety, depression or related intimacy issues, raise opportunities for physicians to connect patients with outside support.

“These issues can negatively affect a patient’s health and treatment progress,” Dr. Dikranian says. “Yet a patient may not want to bring up [a sensitive topic] unless we are proactive listeners.”