Dr. Kelly Haskard-Zolnierek:
Improving communication between doctors and patients
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Dr. Kelly Haskard-Zolnierek
If you don’t always follow your doctor’s recommendations, you’re not alone.
Every year, millions of people resolve to adopt a better diet, exercise more, or lose weight, but doctors know the likelihood is low that patients will develop new health behaviors and maintain them. In fact, studies show that between 25 and 50 percent of patients don’t follow their doctors’ recommendations.
What prevents patients from acting on their doctors’ recommendations for better health?
The quality of communication between physician and patient is one predictor of whether a patient follows through on treatment, said Dr. Kelly Haskard-Zolnierek, Assistant Professor of Psychology at Texas State. She conducts studies on communication in medical visits and how it affects patients’ adherence to treatment.
“Access to medical care and insurance certainly affect the patient’s ability to adhere to treatment,” Haskard-Zolnierek said, “but the patient must also understand what change in health behavior is necessary and be motivated to make the change.
“Communication with the physician can determine a patient’s understanding of treatment and their motivation to comply,” she continued. “If patients are dissatisfied with the physician’s form of communication, they’re less likely to follow through with treatment. On the other hand, when physicians are affective communicators—when they are friendly and empathetic, and when they give clear information without using medical jargon—patients are more likely to be satisfied with their treatment and to adhere to it.”
In studies of communication between physicians and patients, Haskard-Zolnierek has found that:
- In the physician-patient relationship, humor can serve a positive function by breaking the ice, relaxing the patient and the physician, and encouraging rapport. It can also be used negatively by both physicians and patients, as in criticism, thereby lowering mutual trust and satisfaction. Haskard-Zolnierek and her students created the Physician-Patient Humor Rating Scale, the first scale to measure humor in exchanges between physicians and patients.
- In another study, Haskard-Zolnierek and her colleagues intervened in a number of existing physician-patient relationships, to see what effect training in communication skills had on the relationship. Physicians were trained in skills such as using empathy, involving patients in their own care, helping the patient to adhere to treatment, and helping the patient to understand and implement healthy behaviors. The patients were trained in becoming more active in their own healthcare. As a result of the training, the patients perceived that the quality of their healthcare increased, and they were readier to recommend the physician. Moreover, physicians experienced less stress in the physician-patient relationship. Haskard-Zolnierek also found that physicians who were trained in communication skills became more dissatisfied with interpersonal factors in their professional lives than did physicians who were not trained. She interprets this finding to mean that, after receiving communication training, physicians became more aware of the difficulties in communicating effectively, a realization that increased their job stress.