S5 - E23.1 - From The EASL Congress: Overview Of Challenges In Physician-Patient Communication

Surfing the MASH Tsunami

Co-chairs Shira Zelber-Sagi and Mike Betel and panelists Tom Marjot and José Willemse, all from the EASL Congress session "Patient Experiences in Clinical Settings," join Louise Campbell to provide an overview of issues in physician-patient communication.
The conversation itself has two elements. It starts with first-time surfers Tom Marjot and José Willemse introducing themselves to listeners. After that, Shira starts by discussing the EASL Congress session within the context of a broader collaboration called "EASL Patient Synergies." This program led to the creation of the Patient and Advocate Forum as the EASL Congress, which led to this program. She says this year's program "worked" in developing "very interesting and fruitful and open dialog between patient and patient representatives and physicians," focusing on unmet patient needs and the roles various providers can play in addressing these. Mike shares one of his key takeaways: how fearful patients are when approaching physicians and how little information they share.
Mike recalls a comment Tom made during the session that if a patient ever told him, "What you just said hurt me or made me feel bad," that would have more impact on him than, as Tom puts it, "an entire weekend at a stigma workshop." Tom describes three levels at which to address patient stigma. Two of these, public policy and patient advocacy, are well known, but the third, improving direct physician-patient interaction, may be more vital and is underappreciated today. If patients provided direct feedback to Tom when Tom was communicating poorly, he says, he could adjust with the very next patient. Today, though, he doesn't get that kind of feedback.
Jose sees this as a two-way problem. Yes, most patients are fearful and do not share what they are thinking with the provider, but the reverse is true as well. When a patient shares feelings with a provider, the provider may not be equipped to handle it. She makes this point about provider insensitivity or failure to listen with two powerful vignettes.
Tom recalls Jose telling him in Milano that when the physician turns off the computer screen, it changes the entire dialogue with the patient. He has begun to do so, and it works! Jose makes a couple of points about this. First, simply asking that patient, "How do you feel?" and engaging with the answer makes the patient more satisfied with the visit. Second, this speaks to the idea that physicians do not realize how important they are in the lives of their patients.