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Communication key with unhappy patients by Erin L. Boyle Senior Staff Writer Body language and communication techniques can have major impact on physician/ patient interaction C ommunication between a physician and patient, at the best of times, can be fraught with complexities ranging from patients not understanding medical terminology to disliking the physician's bedside manner—but those complexities can be even more pronounced in cases of angry patients. Physicians would do well to arm themselves with ways of improving their overall body language and communication skills, especially in dealing with unhappy cases, experts say. "Usually the challenges of communication, at least in healthcare, are going to be challenges involving emotionally difficult, emotionally evocative situations, and those situations are usually going to be around painful feelings. [These feelings] involve, for example, a disappointing clinical outcome, having to break bad news, being with a patient who you don't like," said John Banja, PhD, Emory University Center for Ethics, Atlanta. "[What] any healthcare professional needs to keep in mind in these kinds of situations is how important it is to be skillful at sensing and being able to shape the emotional atmosphere of the conversa- tion," he said. "That is critical because usually these kinds of communications are not about information. They are largely about feelings." Body language is important in helping to convey the feelings of both parties—as is the manner in which a person speaks and listens, among other actions. Body language "conveys a message, and physicians should be sure the message is what they want to convey," said Doyle Stulting, MD, professor emeritus of ophthalmology, Emory University, Atlanta. "I think it's important that we have a relaxed interaction with patients, and we convey to them friendliness and openness without authoritarianism," said Nick Mamalis, MD, professor of ophthalmology, John A. Moran Eye Center, Department of Ophthalmology & Visual Sciences, University of Utah, Salt Lake City. "Patients already view doctors as an authority figure, and we want to be very careful that we don't come across as someone who is superior." Dealing with angry patients The physician/patient relationship can break down when patients are unhappy with care. According to information provided by Dr. Banja, angry responses from patients can range from "Do you people really know what you're doing?" to "Are you licensed?" to "Let me tell you something ... " Patients can target physicians with the worst of their anger about medical outcomes, he said. Patients want four basic responses from physicians—understanding, respect, curiosity, and vitality, Dr. Banja said. Patients want to be heard. They want an empathetic response from their physicians. But communication will sometimes fail if patients are continued on page 24 December 2013 • Ophthalmology Business 23