How Essential Is Doctor-Patient Communication To Whole Health?

Nurse-Patient Communication

At the National Health Policy Conference held in Washington, D.C., members of the Agency for Healthcare Research and Policy agreed that the need for research focusing on the doctor-patient relationship was urgent in order to address the current crisis of patient dissatisfaction, medical-error, malpractice claims and physician burnout. Communication between the patient and all practitioners or  caregivers is thus an essential component of any whole health approach.

Patients are not happy, doctors and medical teams are not happy, and the health care system is struggling to adapt measures to turn the tide of this growing problem. The 2012 Institute for HealthCare Communication (IHC) report regarding research on the impact of poor communication revealed the following:

  • Research conducted during the 10 year period of 1995-2005 has demonstrated that ineffective team communication is the root cause for nearly 66 percent of all medical errors during that period.
  • This means that when healthcare team members do not communicate effectively, patient care often suffers.
  • Further, medical error vulnerability is increased when healthcare team members are under stress, are in high-task situations, and when they are not communicating clearly or effectively.

The research from the IHC reports cites that 50% of all malpractice is the result of poor communication between doctor and patient.

The IHC report states: “Research evidence indicates that there are strong positive relationships between a healthcare team member’s communication skills and a patient’s capacity to follow through with medical recommendations, self-manage a chronic medical condition, and adopt preventive health behaviors. Studies conducted during the past three decades show that the clinician’s ability to explain, listen and empathize can have a profound effect on biological and functional health outcomes as well as patient satisfaction and experience of care.”

IHC goes on to make an alarming statement that “Extensive research has shown that no matter how knowledgeable a clinician might be, if he or she is not able to open good communication with the patient, he or she may be of no help.”

And, while the addition of nurse health coaches to the medical team has been viewed by some as a solution to the communication problem, the relationship between the physician or primary care provider and the patient cannot be corrected by these additional team members. In fact, not addressing the underlying cause of doctor-patient discomfort may even increase the distrust and discomfort the patient experiences with their doctor or primary care provider.

As physicians, physician assistants and nurse practitioners are the diagnostic experts in our medical care system, ensuring the communication between these providers and their patients is critical, as research data demonstrates.

A recent pilot study, conducted through Central Michigan University (CMU), on the effects of a communication model, Behavior Engagement with Pure Presence, on patient and physician satisfaction has just concluded, and will be published shortly. The study was funded by Blue Cross and Blue Shield Foundation of Michigan.

The Primary Investigator (P.I.) of this study, Dr. Christine Clipper, wanted to thoroughly test the Behavioral Engagement model by including renowned endocrinologist, Dr. Opada Alzohaili, who was trained in the model’s communication skills and had previously earned high patient satisfaction survey ratings. Dr. Alzohaili’s post-pilot patient satisfaction scores were significant, revealing 100% improvement on all measures of patient perception of relational empathy during their encounter with the doctor, in contrast to his pre-pilot patient satisfaction scores.

Dr. Clipper’s research data demonstrated that Behavioral Engagement with Pure Presence has “…a psychological effect on the patient’s perception of the patient-provider relationship. The patient perception of relational empathy with their doctor increased through improved provider communication skills through applying the Behavioral Engagement model.”

Further research on the application of the model includes a pilot study on the Behavioral Engagement model in Electronic Medical Record Communication, funded by the U.S. Department of Health and Human Services/ MI Dept. of Community Health;
and a randomized controlled clinical trial study with funding from major national health care organizations.


For more whole health discussions like this, listen to Dr. Georgianna Donadio’s radio show Living Above The Drama.

 

Can One Drink a Day Increase Your Cancer Risk?

By now, everyone has heard about the benefits of red wine — that it’s packed with heart-healthy antioxidants and resveratrol, which may reduce bad cholesterol and help prevent blood clots [1]. But, as doctors have long known, there is another alcohol and cancer link. Namely, drinking alcohol is associated with an increased risk of developing cancer.

The Research

The Million Women study followed the behaviors, lifestyles and reproductive habits of women over the course of a seven-year period. It found that 13 percent of certain cancers were linked to alcohol use [2]. Women who were heavy drinkers were more likely to be affected. The cancers linked to alcohol use included: mouth, throat, esophageal, breast, liver and rectal.

Certain types of cancer are more pervasive depending on one’s alcohol habits. For example, mouth cancer affects up to 70 percent of heavy alcohol drinkers. Those imbibing five or more alcoholic drinks per day are more likely to suffer from cancers of the upper digestive tract. Three or more drinks per day can increase cancer risk by up to 41 percent in men. Two or more drinks per day increases the risk by 20 percent in women.

All Or Nothing

With news like this, it’s understandable that some people might rush to clear out their liquor cabinets and completely abstain from even “one more drink.” The key, however, is knowing that cancer deaths linked to alcohol overall is quite small — an estimated 2 to 4 percent. But it’s still worth noting that these deaths could have been prevented just by enjoying alcohol in moderation.

As mentioned in the opening paragraph, doctors still acknowledge the benefits of drinking a glass of red wine. It appears to be good for the heart, and promising research has been done on the topic of resveratrol. However, the resveratrol studies have so far only been performed on mice — not humans [3]. To get the measured benefits of resveratrol noted in the studies, you would have to drink 15 gallons of red wine every day!

Is Red Really Best?

There are also noted benefits found in the alcohol itself, such as a 25-40 percent decrease in cardiovascular disease with moderate drinking [4]. These specific conditions include: peripheral vascular disease, ischemic stroke (caused by a blood clot), sudden cardiac death and other cardiovascular issues. Moderate amounts of alcohol also raise the body’s “good” cholesterol. There are additional social aspects, such as drinking with friends or a stress-relieving drink at the end of a hard day of work [5].

The specific type of alcohol involved in reducing cardiovascular risk does not seem to matter — beer, wine, vodka and other types all seem to bestow the same effects.

With this in mind, what are the best ways to drink in moderation safely?

  • Time Frame Matters: Someone who has 5-7 drinks on a Friday night might think they’re getting the same benefits as someone who has one drink a day (if they can think straight at all), but binging on alcohol can have the opposite effect, including liver and other organ damage. Spread your alcohol consumption over a longer time period rather than guzzling it all at once.
     
  • Drink With a Meal: Having food in your stomach slows the rate of alcohol absorption, which is why more people feel hungover after drinking on an empty stomach. Drinking before a meal may also aid digestion.
     
  • Know Your Risks: If you have a family history of breast cancer, for example, it’s probably not a good idea to hit the bottle often. Understand the genetic links between alcoholism and cancer as it applies to your unique makeup.
     
  • Talk to Your Doctor: Don’t be embarrassed to talk to your doctor about your drinking habits. Certain prescription and over-the-counter medications can interact with alcohol and lead to severe side effects. Tell your doctor how many drinks you have per day (on average) and ask whether or not this may affect the medicines you’re taking.

In Summary

Knowing the risks and benefits of drinking is about more than just issuing “one size fits all” advice. Your family history, genetic makeup and susceptibility to cancer and alcoholism should all play a role in your decision to drink.

Even your mental health (such as whether or not you’re suffering from depression) can upset the balance and lead to addiction. Other factors such as your gender, level of physical activity, smoking habits and so forth will also play a role in how much alcohol your body can realistically tolerate, and if the health payoff is truly worth it.

 

FREE Whole Health Consultations available.
888-354-4325 Take charge of your health