Communication skills in disorders of gut-brain interaction

(doi:10.24875/NGL.19000050)

Douglas A. Drossman, Center for Functional GI and Motility Disorders, University of North Carolina, Drossman Gastroenterology, North Carolina, USA
Johannah Ruddy, Rome Foundation, Chapel Hill, Raleigh, North Carolina, USA

Changes in Western healthcare have raised challenges to the patient-provider relationship (PPR). Clinicians are faced with pressures to see patients in less time due to lower reimbursement for services and increased administrative tasks like the electronic medical record. As a result, the medical interview and physical examination are becoming abbreviated and the value of the PPR is diminished. Now there is less patient and provider satisfaction and loss of meaningfulness in the interaction. This difficulty is particularly a problem for patients with disorders of gut-brain interaction, where perhaps due to time pressure, clinicians give them lower priority than for patients with acute or structural illness. In turn, patients experience a diminution in their role in the relationship and feel frustrated, less connected to their providers, and at times, feel stigmatized. We propose that proper attention to communication skills that improve patient-centered care will reverse these factors. The result would be clinical visits that are more informative, and time-efficient and optimization of PPR. This paper: (1) discusses the issues leading to clinical and societal factors that interfere with the PPR, (2) provides the rationale for learning communication skills to improve the PPR, and (3) offers strategies and guidelines to help the clinician re-establish the clinical skills to improve the PPR.

Keywords: Communication skills. Patient-provider relationship. Patient-centered care. Disorders of gut-brain interaction. Irritable bowel syndrome.