Enhancing communications for better patient outcomes

Effective patient-provider communication is essential to ensure the best possible treatment outcomes for patients with HIV and other chronic diseases. Patients with HIV who report better relationships with their providers are more likely to begin antiretroviral therapy and to remain adherent to long-term care. Many studies have shown that healthcare providers interact differently with their minority patients, who in turn report lower levels of satisfaction with the healthcare that they receive. In their conversations with minority patients, providers are more likely to restrict themselves to biomedical issues, to engage less on interpersonal or psychosocial topics, and to exert greater verbal dominance. Communication problems are especially challenging for patients with language barriers, who are less likely to access a variety of healthcare services. Reliance on family members or other ad hoc translators often results in incomplete transmission of health information between patient and provider. Regardless of the patient's language or culture, it is essential to understand the patient's perspectives toward HIV infection and treatment in order to identify and overcome barriers to treatment. Providers often fail to engage the emotional concerns of their patients, either because they do not recognize statements about emotional well being, because they do not feel competent to engage patients on these topics, or for other reasons. Several practical steps can help providers to improve their use of empathy in patient-provider communication.