Physician-Patient Communication: A Case Study

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Since pain is such a widespread issue it is important to understand its etiology and mechanism in order to have effective doctor-patient communication. The traditional biomedical model for an acute injury does not explain the pain observed in those who have chronic pain disorders (Aronoff, 2016). There are multiple pathways for various types of pain and treatments can be targeted toward that specific path. The central nervous system, genetic, and psychosocial aspects affect various pain pathways (Aronoff, 2016). In one study by Haskard-Zolnierek (2012) a 47-item scale called Physician-Patient Communication about Pain (PCAP) was developed for assessing doctor-patient communication about pain. This study was part of a larger study that focused …show more content…
A review by Butow and Sharpe (2013) analyzes why patients do not adhere to treatment recommendations. The term non adherence has been a source of disagreement for several decades and was originally defined as compliance, or the degree to which a patient’s behavior corresponds with medical advice (Butow & Sharpe, 2013). One concern is that this has an authoritarian connotation that has lead many to use alternative words such as cooperation, collaboration, and concordance; adherence is now the preferred term. Communication plays an important role in treatment adherence. For chronic pain patients they begin the treatment cycle with their PCP as a treatment failure. Many providers consider these patients as having failed the normal plan of treatment, but patients do not view themselves as having failed and instead view the previous treatments as having failed them. This leads to a brutal cycle of frustration that generally causes a breakdown in communication because the patient does not feel heard and the physician feels helpless to intervene. This also makes it more likely that the patient will not adhere to future treatment recommendations and a lower likelihood of the PCP recommending the most suitable treatment (Butow & Sharpe, 2013). Specific strategies that enhance treatment adherence are not very different than those that, in general, promote effective doctor-patient relationships. The UK National Institute for Health Care Excellence (NICE) emphasizes a frank, open-minded, and honest approach when asking about treatment adherence (National Institute for Health and Clinical Excellence, 2009). They also emphasized the importance of acknowledging how common non adherence is; exploring possible barriers and ways to facilitate adherence; providing verbal and written information without medical jargon; customizing communication to the patient’s individual preferences; and a patient-centered
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