AI will not replace physicians

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Never has communication between doctors and patients been more important than today. There is concern that artificial intelligence will reduce jobs in medical practices and threaten to do away with healthcare providers. However, there is no replacement for a physician who is an excellent communicator, has compassion for their patients, and can express empathy. Never will a computer be able to hold a patient's hand and express kindness. AI and computers will not replace us.

This article will provide eleven suggestions to enhance your communication skills.

Doctors, hospitals, insurance companies, and malpractice carriers have known for years that there is a direct correlation between patient satisfaction/patient complaints and lawsuits. There is also a correlation between poor communication and increased risk of litigation.

Physicians have always prided themselves on being good communicators. Still, surveys show that they often overestimate their ability to communicate effectively with their patients. A well-publicized study reports that the average doctor interrupts a patient after sixteen seconds during the interview process.1 So, what can physicians do to improve their communication skills and lower their risk of lawsuits? Following are some suggestions:

1. Prepare for your visit with the patient. Before entering the room, look at the chart or the electronic medical record and know one or two facts about a new patient. This can be the patient's referring physician, employment, or where the patient lives. The same applies to an existing patient. Don't initiate the conversation by talking about the patient's medical problem. Regardless of your patient volume and how far behind your schedule, start the discussion with a topic not associated with the patient's health issues. This conveys that you care more about the patient than their blood pressure, shortness of breath, or dysuria.
2. Sit down—don't stand—while speaking to a patient. Make every effort to be eyeball-to-eyeball with the patient. Never have a meaningful discussion when you are standing, and the patient is sitting—or even worse, when the patient is lying on the exam table.
3. If possible, don't have any psychological or physical barriers between you and the patient. Be on your patient's side of the desk or exam table.
4. Lean slightly forward when you speak to the patient. The patient will notice your body language before you open your mouth. Leaning forward in your chair demonstrates a sincere interest in the patient.
5. Lock eyes with the patient. People usually make eye contact 70% to 80% of the time. If you fall below this average, you come across as shifty or lacking confidence. Physicians who make less eye contact aren't aware of it, so ask a colleague to critique your eye contact.
6. Smile. Keeping a neutral face may feel natural, but the other person might perceive your expression as unfavorable. People are looking for signs of approval, and the lack of a smile may even seem threatening and can make a patient defensive.
7. Don't spend all your time looking at the chart or the computer. One of the most common complaints by patients is that the doctor spends more time looking at the computer than at the patient. 
8. Don't turn your back on the patient. This is disrespectful and a barrier to good communication. Avoid placing wall-mounted computers in the corner of the exam room in such a way that your back is toward the patient. This is certainly one advantage of mobile tablet PCs over fixed computers in the exam room.
9. Minimize interruptions. It can only derail your communication with your patient if interrupted during the visit. Returning to the exam room after an interruption takes work to get the train of thought moving in the right direction. For example, when another physician calls to speak with you, suggest that the receptionist ask the caller if the call is an emergency? If not, then return the call when you are between patents.
10. Walk the patient yourself or have a nurse\medical assistant accompany the patient from the exam room to the check-out counter. Not only is this an excellent courtesy and a sign of respect, but it also ensures that the patient will take care of the bill and make their next appointment.
11. At the end of the doctor-patient encounter, ask if the patient has any additional questions. Upon arrival in the office, I provide the patients with a card and encourage them to write down questions they would like to ask during the encounter. (See Figure 1) This avoids the situation where the doctor believes the visit is over and prepares to leave the exam room. The patient may have an additional question when the doctor has their hands on the doorknob. Using this card avoids that situation and reduces the number of calls to return to patients with further questions.

It is a fact that nearly every doctor will be involved in a lawsuit at some time during their career. Only one in 100 doctors will make it through a career without facing a lawsuit.2 Although few lawsuits result in a damage award, the toll a lawsuit takes on a doctor, their practice, and their family can be daunting. You can do damage control and stave off a lawsuit if you polish your communication skills and follow a few of the recommendations mentioned in this article.

Bottom Line: AI is going to change the way we practice medicine. However, AI can’t hold a patient’s hand, and will never replace the kind, compassionate, and physician who has good communication skills.

Figure 1

Neil Baum, MD, a Professor of Clinical Urology at Tulane University in New Orleans, LA. Dr. Baum is the author of several books, including the best-selling book, Marketing Your Medical Practice-Ethically, Effectively, and Economically, which has sold over 225,000 copies and has been translated into Spanish.

References

1. Groopman, J., & Hartzband, P. (2012). Your medical mind: How to decide what is right for you. Penguin Books.

2. Stelfox HT, Ghandi TK, Orav EJ, Gustafson ML. The relation of patient satisfaction with complaints against physicians and malpractice lawsuits. Am J Med. 2005;118:1126-1133.