Physician-Patient Communication

Did You Know: Physician-patient communication has the greatest effect on patient education and patient satisfaction.

• Dissatisfied patients are more likely to reject recommended actions, miss appointments, turn to non-medical healers, and sue for malpractice.
• Non-verbal behavior of the health care provider appears to influence patient satisfaction.
• Among elderly ( 65+) there is an average rate of adherence ( following the physician's recommendation/s) of 45%.

Physicians consistently overestimate the amount of time spent giving information to patients, and frequently underestimate the patient's desire for information. Of a typical patient-physician encounter, researchers have found that less than 2 minutes was spent on the transmission of information.

Patient education often fails because:

• More than half of the medical instructions given by physicians could not be recalled accurately by patients immediately after they left the consulting room.
• Two-thirds of patients forgot their diagnosis and treatment explanations, and one half forgot instructional statements immediately after an office visit.
• Sixty percent of patients misunderstood what their physician said about taking medications.
• 21% to 51% of patients do not read the written materials with which they are provided, and in North America, over 12 million adults cannot read beyond the fourth grade level.

Communication is a part of the "art" in the art and science of medicine.

Not every physician or health care provider is a good communicator. How do you tell the difference? A poor communicator may leave you, as a patient feeling intimidated, confused, or dissatisfied with the level of service.

What you can do to improve communication with your physician:

• Have a list of all medications you are currently taking, including over the counter drugs or supplements.
• Provide your physician with an accurate account of the problem ( when it began, symptoms, medications,etc.), and also discuss your own beliefs about why you have this problem.
• Request that he or she talk directly and slowly. Request that they repeat information you may not have heard or may not have understood.
• Be aware of the fact that your doctor is going to pay the most attention to what you say in the first five minutes or so of your visit. Prioritize your concerns, and don't allow your spouse or others to speak for you.
• If you are discussing important decisions like surgery or specialized treatments, take time to think it over. Request another appointment to go over questions, and if you think needed, request a second opinion.
• Invite your spouse or other family member, or a trusted friend to accompany you on your appointments. They can take notes for you to review later, and help remind you of informatio you may have missed.
• As a competent adult, you have the right to accept or refuse medical procedures. You should never make a decision with a feeling of pressure or coercion.
• If you feel that you absolutely cannot communicate with your physician, that they are rude, or unresponsive to your needs...begin to look for another physician.

Changes in health care delivery are having an impact on all of us, whether providers or patients. Because of these changes, perhaps now, more than ever, patients and health care providers need to communicate better. The result will likely be improved patient and provider satisfaction, reduced health care spending, less risk of malpractice lawsuits, and improved medical outcomes.

Passion for Parkinson's

Thank You Denver and DBS Voices of The Rockies


This past Saturday, I had the pleasure of providing a Voice Aerobics seminar in Denver. As usual, I was impressed with the impressive backgrounds of many of the participants. Present on Saturday were accomplished go-getters, now using those same skills to learn how to live well despite various symptoms from Parkinson's Disease. I was asked, prior to the seminar, why  my interest in Parkinson's. I have shared my response below:

I am often asked why I am so passionate about working with people with Parkinson’s Disease.  First, I see a collage of faces of patients I have worked with over many years of my career as a speech-language pathologist. Many of them came quietly into my treatment room, ushered in by well-intentioned spouses, who announced the reason for the visit. Once the spouses left, however, I often uncovered a bright and interesting person, a former CEO, a pharmacist, a teacher, full of wit, their true spirit masked by their disease and with speech that was poorly understood by most. I felt compelled to help them regain their voices before they were lost completely. Many had already acquired a different self-image and the spouses, in addition to their caregiver roles. had  already taken on the role of the main communicators.

Second, a few years before my dad’s retirement at the age of 80, he began to exhibit Parkinson’s symptoms, including speech and swallowing problems, I felt equally compelled to help him. ( Despite my usual warning that children and spouses do not make good therapists). On one visit with him out of state, I accompanied him to a doctor's appointment. He appeared to me as if he had had a TIA or a mini-stroke. The doctor, who was covering for my dad's regular doctor, said to me in hushed tones something about dementia. I was horrified. My father had NO cognitive issues but I realized, to strangers, that his affect, speech, and other mannerisms now gave that impression. It saddened me, that my dad, who had always been very talkative, was withdrawing into the role of silent observer.

I am driven by a passion and a belief that our ability to speak is our most precious human gift. When sitting face to face with participants in a Voice Aerobics session, I feel that sometimes my eyes reach into their souls and touch their spirit for that brief encounter. How could I not want to do this all the time? It is so life giving to me. It is a gift to give — voice which opens up one’s soul to others.

My Mission: To enlist individuals in their treatment, and help them express their personality and spirit through voice. To educate and empower.

 Thank you for allowing me to participate in your care.


What Participants are saying:
                                                                                                    

“I attended your October 30, 2010 presentation of Voice Aerobics to learn more about supporting my Parkinson's friends. Well, the invaluable information was wonderful for them, but also for me, personally. As someone dealing with Post-Polio Syndrome including upper body and respiratory system deficits, your Voice Aerobics added fun and focus to my overall exercise routine. Thank you!”

Bonnie McPartland, Post-Polio

"The best part of the cruise?" I enjoyed the voice aerobics so much. it's right up my alley and something I really needed. The woman was kind and attentive, and we even received her voice aerobics disc in our goodie bag. I've played it at home and can see a real difference." Bill O'Keefe, Ft Lauderdale, Florida (PRF Bahama cruise 2010)

Hi, Mary! Wanted to thank you again for your vibrant and enthusiastic presentation at the Voice Aerobics workshop this past Saturday! It was informative and thought-provoking, while at the same time a barrel of fun!! If only, the more traditional aerobics classes which I attend were half as engaging!!

As one of those who did not previously think I had any voice or speech issues which necessitated any concern, I now realize, thanks to your workshop, that even if this is true, all the more reason to commence a daily “practice” incorporating the techniques which you have pioneered to insure that this continues to be the case in the future.

Valerie Graham, DBS Voices of the Rockies