Take both patient and physician needs into account

• Develops a partnership – a collaborative relationship
• Patient: their own personal hierarchy of concerns
• You: the patient’s most pressing medical concerns, time constraints, etc.
• ‘I understand that your knee arthritis is really bothering you today, but if you don’t mind, I’d like to start off talking about those chest pains you’re having’

Make the structure of the interview overt

• Allows the opportunity for patient involvement and more responsibility
• ‘Let’s start with your new problems – the diarrhea and fever – then circle back to the issues you’ve been having with your medications’

 Establish and negotiate priorities for the consultation

• Clear communication promotes an interaction rather than direct information transmission
• ‘Let’s discuss those headache and then look at your rash. I wouldn’t mind checking your blood pressure as well if that’s alright’

Exercise: For your next patient encounter, after eliciting your patient’s concerns and negotiating an agenda, map the proposed outline of your interview in your notes. If you become stuck (i.e. “time out”), reflect on your outline and see…

1. Where are you in the interview?
2. Where are you trying to go?
3. How you will get there?

Silverman, J., Kurtz, S., & Draper, J. (2013). Skills for Communicating with Patients (Thrid Edit). London: Radcliffe Publishing.