Thursday, July 21, 2011

Interpersonal Skills

Here are five things orthopedic surgeons can do to communicate better with their patients.
1. Develop good interpersonal skills. Patient satisfaction is about more than good outcomes and if surgeons don't have excellent interpersonal skills, the patient will often be dissatisfied regardless of the outcome. "Have good bedside manner and make sure you have good people on the phones," says Peter Althausen, MD, an orthopedic surgeon at Reno Orthopaedic Clinic and chairman of the board of directors of The Orthopaedic Implant Company. "We established a code of conduct to make sure patients are treated appropriately." Surgeons should introduce themselves when they enter the patient's room, smile at the patient and stand without their arms crossed when engaging in conversation. Use appropriate language to discuss the patient's treatment and make sure they understand every step of the process. "These things really make patients feel better," he says.
2. Communicate in metaphor. It can sometimes be difficult for orthopedic surgeons to relay information about a particular condition or procedure, especially if it is complex. But, it is important for the patient to know what is going on with their bodies, says David Marshall, MD, medical director of the sports medicine program at Children's Healthcare of Atlanta. Communicating with them through metaphor can bridge the gap between the scientific process and the patient's understanding for their problem. For example, one of the injuries that could occur in young athletes is overextending the growth plates. Since the growth plates in young athletes are still cartilage instead of bone, they cannot withstand as much activity as older athletes can. Physicians are able use a multitude of diagrams and models to show athletes what happens when they overextend themselves. However, for some children, using ametaphor could help visualize the process of overuse.
Dr. Marshall tells young patients that the muscle, joint and growth plate are like a big cable attached to a screw attached to a plastered wall. The cable and screw can be strongly bound, but if the plaster is still wet and someone pulls on the cable, the anchor will give away regardless.
3. Take time a little extra time to learn about patients and their goals. For too long, surgeons have hidden behind barriers to remain objective, and become inaccessible as a result, according to Paul Slosar, MD, an orthopedic spine surgeon with SpineCare Medical Group in San Francisco. Aim to know something about each patient — whether about their job, where they live or what hobbies they enjoy. This builds a catalog of experiences that helps Dr. Slosar develop a sense of patients’ post-surgery behavior. After developing an understanding of their personality and interests, he can then slow patients down or encourage their return to aerobic activities, making the spine surgery fit comfortably within their lifestyle.
4. Develop a treatment and recovery plan in partnership with your patients. Patients will appreciate your effort to work with them on a plan toward recovery. Peter Millett, MD, a sports medicine physician at The Steadman Clinic in Vail, Colo., says although he makes the recommendations for what the best treatment plan would be to patients, he strives to work with the patient and involve them in the final treatment decision. This can only be achieved by determining what the patient's goals are from the outset.
"For example, I may see two patients who are in need of rotator cuff surgery," he says. "But one patient, because of his or her activity level, may need one specific set of treatments, and the other patient may need an entirely different treatment plan because this patient's activity or sport is different. It's about individualizing and personalizing the care."
5. Use the Internet to reach patients at home. Many patients, including young athletes and baby boomers, regularly use the Internet and orthopedic surgeons can use this space to their advantage. Thomas Vangsness, MD, chief of sports medicine at the Keck School of Medicine at USC and the LAC/USC Medical Center, has created YouTube videos of different shoulder and posturing exercises and uploaded them onto his website for patients to use at home. "I tell my patients to go to my website and follow the different exercises for knee and shoulder issues," he says. "For many patients, the videos are a lot better than giving them little sheets of paper with exercise descriptions and pictures. They can actually see how to do their exercises."