4-1

Communication with Patients,

Families, and Coworkers
PowerPoint presentation to accompany:

Medical Assisting
Third Edition
Booth, Whicker, Wyman, Pugh, Thompson
2009 The McGraw-Hill Companies, Inc. All rights reserved

4-2

Learning Outcomes
4.1 Identify elements of the communication
circle.
4.2 Understand and define the developmental
stages of the life cycle.
4.3 Give examples of positive and negative
communication.

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Learning Outcomes (cont.)

4.4 List ways to improve listening and
interpersonal skills.
4.5 Explain the difference between
assertiveness and aggressiveness.
4.6 Give examples of effective communication
strategies with patients in special
circumstances.
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Learning Outcomes (cont.)

4.7 Discuss ways to establish positive
communication with coworkers and
management.
4.8 Describe how the office policy and
procedures manual are used as a
communication tool in the medical office.

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Learning Outcomes (cont.)

4.9 Describe community resources and how
they enhance the services provided by
your office.
4.10 Explain how stress relates to
communication and identify strategies
to reduce stress.

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Introduction

Medical assistants must

Recognize human behaviors

Communicate effectively,
with professionalism and
diplomacy
Recognize obstacles that
affect therapeutic
communication

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Communicating with Patients

and Families

You are the key communicator between the

physician and patient

Your interaction sets the tone for the office visit

Developing strong communication skills is just as

important as mastering administrative and clinical
skills
Communication will influence how comfortable the
patient feels in your practice.
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Communicating with Patients

and Families (cont.)

Customer service

Pati
ents
a re
#1!

Most important part of

communication

Two points fundamental to customer service

The patient comes first

Patient needs are satisfied
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Communicating with Patients

and Families (cont.)

Examples of customer service

Telephone techniques

Writing or responding to telephone

messages

Explaining procedures to patients

Assisting with billing issues

Creating a warm and reassuring

environment
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Apply Your Knowledge

What are the two key parts of customer
service?
ANSWER: The two fundamental parts of customer
service are that the patient comes first and you must
satisfy patient needs.

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The Communication Circle

The communication cycle involves an

exchange of messages through verbal and
nonverbal means.
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Communication Process

Patients often believe that health care has

become impersonal due to

Technological advances
Managed care organizations

Maintain a patient-centered approach

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Apply Your Knowledge

What are the three elements of the
communication circle?
ANSWER: The three elements of the
communication circle are the message, source,
and receiver.
RIGHT!

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Human Behavior: Stages of the

Life Cycle

Understanding growth
and development
enhances
communication skills

Physical development
Psychological growth

Guidelines for
communication based
on developmental stage

Infant
Toddler
Preschooler
School age
Adolescence
Young, middle, old
adult

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Maslows Hierarchy of
Human Needs
Self-Actualization
Esteem Needs
Love Needs
Safety Needs
Physiological Needs

Deficiency Needs
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Apply Your Knowledge

You can communicate with all people in the same way.
Is this statement true or false, and why?
ANSWER: The statement is false. Not all people are at the
same place on Maslows hierarchy of human needs. To
communicate effectively with a person, you need to
understand what he or she is deficient in. For example, you
would use different communication styles when talking to a
homeless person who may have psychological and safety needs
than when talking to an elderly person who is lonely and
depressed due to the recent loss his or her spouse.

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Types of Communication

Positive or negative

Verbal or non-verbal

Written (Chapter 7)

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Positive Communication

Communication promotes
the patients comfort and
well-being

Set the stage for positive

communication

Encourage patients to ask

questions

Speak slowly and clearly

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Negative Communication

Curb negative communication habits

Mumbling
Speaking brusquely
Avoiding eye contact
Interrupting patients as they speak
Rushing explanations
Forgetting common courtesies
Showing boredom
Treating the patient impersonally
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Body Language

Facial expression
Eye contact
Posture
Open
Closed
Touch
Personal space

In many instances, peoples body language conveys their

true feelings, even when their words may say otherwise.
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Apply Your Knowledge

YEA!

Mr. Garcia comes to the desk to check in and asks if he will be

seen on time. The receptionist continues with her paperwork,
points to the sign-in sheet, and tells Mr. Garcia: Just sign in.
The doctor will be with you when he can. Explain why this is an
example of negative communication.
ANSWER: This is an example of negative communication because the
clerk
Did not stop what he or she was doing was not friendly or attentive
Did not greet Mr. Garcia or make eye contact with him
Did not give a satisfactory answer to Mr. Garcias question
Did not make sure Mr. Garcia understood when he would be seen
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Improving Communication Skills

Listening skills

Passive listening

Active listening

Improve listening skills

Prepare to listen

Relax and listen attentively

Maintain eye contact

Maintain personal space

Think before you

respond

Provide feedback

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Improving Communication
Skills (cont.)

Interpersonal skills

Warmth and
friendliness
Empathy
Respect
Genuineness
Openness
Consideration and sensitivity
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Therapeutic Communication

The ability to communicate with patients

In terms they can understand

So they feel at ease and comfortable

The ability to communicate with other

members of the health-care team

Technical terms
Appropriate to the health-care setting
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Therapeutic Communication (cont.)

Involves

Silence

Accepting

Giving recognition
Offering self

Encouraging
communication

Mirroring

Reflecting

Focusing

Giving a broad opening

Exploring

Offering general leads

Clarifying

Making observations

Summarizing

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Ineffective Therapeutic
Communication

Roadblocks

Reassuring

Probing

Giving approval

Defending

Disapproving

Agreeing/
disagreeing

Requesting an
explanation

Minimizing feelings

Advising

Making stereotyped
comments

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Defense Mechanisms

Unconscious, designed to protect self

Patients may display

Compensation
Denial
Displacement
Dissociation
Identification
Introjection
Projection
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Assertiveness Skills

Assertive people who are firm and stand by

principles while still showing respect for others

Requires

Openness
Honesty
Directness

Aggressive people who try to impose their

position on others or try to manipulate them
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4-29

Apply Your Knowledge

What is the difference between being aggressive and being
assertive?
ANSWER: Assertiveness means standing by your principles
while showing respect for others. You trust your instincts,
feelings, and opinions and act on them. An aggressive person
tries to impose his or her own position on others or tries to
manipulate them. He or she is bossy, may be quarrelsome, and
does not consider others feelings, needs, thoughts, ideas, or
opinions.

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Communication in Special
Circumstances

Anxious patient

Can interfere in communication process

May not listen well or pay attention to what you are

saying

Observe for

Tense appearance
Increased blood pressure and breathing
Sweaty palms
Irritability and agitation

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Angry Patient

Goal is to help the patient express anger constructively

Steps in communicating with an angry patient

Recognize anger and its cause

Remain calm and demonstrate

respect

Ask patient to be specific

concerning cause

Present your point of view

Focus on physical and medical

needs

Avoid breakdown of
communication

Maintain adequate personal

space

Leave if you feel physically

threatened

Do not take anger personally

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Patients from Other Cultures

Each patient has his or her own behaviors,

traditions and values

Stereotyping

Strive to understand and be tolerant

Negative statement about specific traits of a group
applied to an entire population

Generalization

Statement about common trends within a group

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Patients from Other Cultures

(cont.)

Attitudes about health

care

Beliefs about causes of

illness

Symptoms and what

they mean

Treatment expectations

Language barriers

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Patients with Visual Impairment

Use large-print materials

Use adequate lighting in all areas

Use a normal speaking voice

Talk directly and honestly

Do not talk down to the patient

Preserve the patients dignity

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Patients with Hearing Impairment

Find a quiet area to talk

Minimize background noise

Position yourself close to and

facing the patient

Speak slowly

Remember that elderly patients

lose the ability to hear highpitched sounds first

Verify understanding

Use written material

Speak clearly but do not

shout

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Mentally or Emotionally Disturbed

Determine what level of

communication the patient
can understand
Suggestions

Remain calm if the patient

becomes agitated or confused
Avoid raising your voice
Avoid appearing impatient
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The Elderly Patient

Be respectful

Do not talk down to elderly

person

Tips for communication

Act as if you expect the patient to

understand
Respond calmly to any confusion
Tell the truth and use simple questions and terms
Ask the patient to relax, speak slowly, and ask the patient to
repeat if you do not understand
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4-38

Terminally Ill Patients

Often under extreme

stress, so offer support
and empathy

Kubler-Rosss Stages of
Dying

Denial
Anger
Bargaining
Depression
Acceptance

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4-39

Young Patients and Their Parents

Recognize and accept their

fear and anxiety
Explain all procedures
Use praise
Do not tell children that a procedure will not
hurt if it will, or you will lose their trust
Reassuring and keeping parents calm will also
help the child relax
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4-40

Patients with AIDS/HIV

Stigma of disease

Guilt
Anger
Depression

You must have accurate

information about the disease
and the risks involved to answer the
patients questions
Patients need human contact and to be treated with
dignity
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4-41

Patients Family and Friends

Provide emotional support to the patient

Acknowledge family members and friends

Keep them informed about patients progress

Remember to protect patient confidentiality

Ask the patient what information can be given to

family or friends.
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4-42

Apply Your Knowledge

What can you do to promote communication with
someone who is visually impaired?
ANSWER: Use large-print materials, adequate
lighting in all areas, and a normal speaking voice. Talk
directly and honestly, but do not talk down to the
patient; preserve the patients dignity.

2009 The McGraw-Hill Companies, Inc. All rights reserved

4-43

Communication with Coworkers

Develop rapport with

coworkers

Rules for the medical office

Use proper channels

Have a proper attitude

Plan an appropriate time for

communication

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4-44

Communicating with
Management

Keep supervisor
informed

Ask questions

Minimize interruptions

Show initiative
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4-45

Dealing with Conflict

Do not feed into others

negative attitudes

Be personable and supportive

Refrain from passing

judgments

Do not gossip

Do not jump to conclusions

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4-46

Apply Your Knowledge

What strategies can you use to avoid conflict in the
workplace?
ANSWER: You can use the following strategies to avoid
conflict in the workplace:
Do not feed into others negative attitudes
Be personable and supportive
Refrain from passing judgments
Do not gossip
Do not jump to conclusions

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4-47

Policy and Procedures Manual

Key written
communication tool

Policies

Dictate the day-to-day

workings of an office
Describe chain of command

Procedures

Detailed instructions for

specific procedures

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4-48

Policies

Office purposes
Rules and regulations
Job descriptions
Office hours
Dress code
Insurance
Vacation and sick
leave

Salary evaluations
Maintenance of
equipment
Mailings
Bookkeeping
Scheduling
appointments
OSHA

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Procedures

Purpose of test, clinical application, and usefulness

Specimen required and collection method

Special patient preparations or restrictions

Reagents, standards, controls, and media used

Instrumentation

Calibration and schedules

Step-by-step directions
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4-50

Community Resources

Good customer service is

founded on providing or
researching services to
assist in attaining the goal
of patient health and
well-being
Discuss with patients
physician before referring
patient

Resources

Alcoholics Anonymous
Shelters
Hospice
Mental health services
Meals on Wheels
PASSPORT
Easter Seals
State agencies
Support groups

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4-51

Other Resources

Reference laboratories

Insurance companies

Office equipment suppliers

Maintenance companies

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Apply Your Knowledge

What is the difference between policies and procedures?
ANSWER: Policies dictate the day-to-day
workings of an office and usually describe the
chain of command. Procedures are the detailed
instructions for specific procedures.

!
t
h
g
i
R
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4-53

Managing Stress

Stress can be a barrier to communication

Stress can occur

Due to a feeling of being

under pressure
As a reaction to anger,
frustration, or change in
routine

Stress is normal

Motivating
More productive
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4-54

Managing Stress (cont.)

Ongoing stress

Overwhelming
Physical effects

Reducing stress

Consider your strengths and

limitations
Be realistic about commitments
both at work and in your private life
Techniques to reduce stress

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4-55

Apply Your Knowledge

List three things you can do to relieve stress.
ANSWER: Any of the following can help you reduce stress:
Exercise regularly

Change what you have control over

Eat a balanced diet

Keep focused

Get enough sleep

Identify sources of conflict

Set realistic goals

Maintain a sense of humor

Be organized

Try not to overreact

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Burnout

Burnout is the end result of prolonged periods of

stress without relief

Type A personality

Highly driven, perfectionist-type person

More susceptible to burnout

Type B personality

More relaxed, calm, laid back

Less prone to burnout
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Burnout (cont.)

Stages to burnout

Honeymoon

Awakening

Brownout

Full-scale burnout

Phoenix phenomenon
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4-58

Preventing Burnout

Take time to rest and

relax

Be realistic about job

expectations, your
aspirations, and your
goals

Create a balance in life

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4-59

Apply Your Knowledge

What are the phases of burnout?
ANSWER: The phases of burnout are
Honeymoon
Awakening
Brownout
Full-scale burnout

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4-60

In Summary
Medical Assistant
You are the key link between the office and patient
Communication Skills:
Listening, interpersonal, and
assertiveness

People with Special Needs:

Anxious, angry, elderly, hearing
and visually impaired

Develop working relationships and help office run smoothly.

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4-61

Often during life-altering

experiences, patients and their
loved ones need a shoulder to
cry on or someone to comfort
them. It is important for them to
know support is there.
Lindsey D. Fisher (The Healers Art)

2009 The McGraw-Hill Companies, Inc. All rights reserved