Study Suggests How Pediatricians May Improve Relationships with Patients and Their Parents
December 23, 2010
Researchers recommend strategies for physicians when relating to particularly stressed or overburdened parents
Stressed parents, physicians needing improvement in communication skills, and a health care system fraught with economic pressures can sometimes lead to difficult encounters between pediatricians and the parents of young patients. According to numerous studies looking at patient/provider relationships in adult patient populations, nearly one out of six outpatient visits in adult practice is considered difficult by physicians. Until now, it has been unclear how this may relate to pediatric practice. In a new study looking at factors affecting pediatricians, led by Cora Collette Breuner, MD, MPH of Seattle Children’s Research Institute, researchers have identified factors in pediatric settings that may contribute to difficult patient/parent encounters. The findings also suggest strategies to improve the pediatric provider/patient/parent relationship. The study, “Approaches to the Difficult Patient/Parent Encounter,” published online December 20 in Pediatrics.
“In pediatrics, physicians need to interact not only with patients, but also with their parents. This adds additional layers of complexity. Understandably, parents may be both very dedicated to and strained by caring for a child with ongoing major needs, for example,” said Dr. Breuner, pediatrician at Seattle Children’s Hospital. “When we can more effectively partner with parents rather than confront them, we increase the likelihood for better compliance with recommended care. Ultimately, we hope this improves the patient’s care and outcomes.”
Based upon data from existing health information databases, Breuner and co-investigator, Megan Moreno, MD, MSEd, identified factors that may contribute to difficult patient/parent encounters in pediatric care. They found that interactions between physicians and parents in pediatric settings can be especially difficult if a parent: has an abrasive or threatening demeanor toward the physician; does not comply with prescribed treatments or medications for their child; or suffers from a mental illness.
Parents of children being treated for chronic illnesses may be considered particularly challenging by some physicians. This group can be especially vulnerable and stressed, since they cope with a very ill child on an ongoing basis. On the physician’s side, the researchers found that those who were younger and with less clinical experience may be more likely to perceive some parent encounters as difficult.
Other contributors leading to difficult parent/provider relationships included language barriers, cross-cultural issues and poor physician communication skills. Additionally, these factors can lead to undesirable patient health outcomes, complaints and lawsuits. Overbooked clinics can also contribute to patient/parent dissatisfaction.
To help improve difficult encounters, Drs. Breuner and Moreno recommend that physicians seek training in additional coping and communication techniques. Understanding patient and parental expectations is associated with improved patient compliance, and can reduce the complaints and fears that may accompany serious illness. They also recommend that physicians consider modifying scheduling systems to increase the time spent with some patients and their parents as increasing patient/parent involvement in the process of care delivery may enhance the provider/parent relationship.
Breuner’s study collaborator was Megan Moreno, MD, MSEd, of the University of Wisconsin, previously affiliated with Seattle Children’s Research Institute.
About Seattle Children’s Research Institute
Located in downtown Seattle’s biotech corridor, Seattle Children’s Research Institute is pushing the boundaries of medical research to find cures for pediatric diseases and improve outcomes for children all over the world. Internationally recognized investigators and staff at the research institute are advancing new discoveries in cancer, genetics, immunology, pathology, infectious disease, injury prevention and bioethics, among others. As part of Seattle Children’s Hospital, the research institute brings together leading minds in pediatric research to provide patients with the best care possible. Seattle Children’s serves as the primary teaching, clinical and research site for the Department of Pediatrics at the University of Washington School of Medicine, which consistently ranks as one of the best pediatric departments in the country. For more information, visit http://www.seattlechildrens.org/research.