The Patient–Physician Clinical Encounter

Abstract

The success or failure of clinical outcomes depends upon specific steps and variables that present during the clinical care process. As healthcare providers, we can control some of these steps and variables, but not others. The most important step in the clinical care process is the patient-physician clinical encounter or "what occurs in the examination room." We can control this most important and sensitive step. For emergency physicians, the clinical encounter represents an even greater challenge; we have only one window of opportunity to make a solid connection and produce a successful encounter. The provider may not know when a failed clinical encounter has occurred, but the patient always knows. The clinical encounter affects trust, patient comprehension, and follow-up, all vital for a positive clinical outcome.Successful encounters are thus valuable/important opportunities for the clinician.Health providers are responsible for establishing an environment for successful clinical encounters. In the examination room, patients are on the physician's turf as an equal partner and a guest and must be treated as both. The goal of the clinical encounter is to establish trust, to educate, and to increase the likelihood for patient follow-up and compliance. This chapter presents background information to support the significance of successful clinical encounters. The chapter will identify commonly-adopted norms and pitfalls physicians can experience and stress necessary cautions and levels of awareness that can aid in avoiding unintentional actions that perpetuate cycles of partial effectiveness and that lead to suboptimal outcomes. The chapter offers five elements for a successful strategy to achieve a positive patient-physician encounter in the examination room:Summary Points

“I Can Understand Where They’re Coming From”: How Clinicians’ Disability Experiences Shape Their Interaction With Clients

“…Communication between a clinician and a client is an important factor that leads to positive health outcomes (Levinson et al, 2010; Thompson & McCabe, 2012), including the effectiveness of the treatment (James, 2016). Race, ethnicity, religion, gender, sexual orientation, and age are recognized in medical education as domains in which various groups may have different care needs and values (Eddey & Robey, 2005).…”

“…Both clinicians and clients bring many factors to bear when they enter a clinical encounter, including their personalities and cultural backgrounds (James, 2016). Misunderstanding underlying cultural factors can have an adverse effect on clinician–client communication, trust, and, ultimately, their treatment (James, 2016; Nivet & Fair, 2016). A client’s clinical experience can have considerable impact on their health outcomes, and shapes their perspective of the health care system (James, 2016; Shakespeare, 2018).…”

Disability Epistemology: Bridging the Gap Between Clinicians' Lived Experiences of Disability and Client-Centered Care

“…Communication between a clinician and a client is an important factor that facilitates beneficial effects on health outcomes (Levinson, Lesser & Epstein, 2010;Thompson & McCabe, 2012). To be effective, however, the clinician must gain an understanding of the clients' i perspectives on their illnesses (James, 2016). Race, ethnicity, religion, gender, sexual orientation, and age are recognized in medical education as domains in which various groups may have different care needs, and different values with regard to health and healthcare (Eddey & Robey, 2005).…”

“…A lack of understanding regarding cultural factors can have an adverse effect on clinician -client communication, trust, treatment, and, most importantly, healthcare outcomes (James, 2016;Nivet & Fair, 2016). Clients' clinical experiences affect their health, shape their perspective on the healthcare system, and influence their healthcare outcomes (James, 2016;Shakespeare, 2018). Both clinicians and clients enter a clinical encounter bringing many factors, such as their personality and cultural background with them (James, 2016).…”

“…Clients' clinical experiences affect their health, shape their perspective on the healthcare system, and influence their healthcare outcomes (James, 2016;Shakespeare, 2018). Both clinicians and clients enter a clinical encounter bringing many factors, such as their personality and cultural background with them (James, 2016).…”