The Physician's Behavior in Therapeutic Communication

based on Patient Perspective in Hospital Education

Medan City

Arfah Mardiana Lubis

, Harmein Nasution

, Zulfendri

and Juanita

Doctoral Program Student of Public Health Faculty, Universitas Sumatera Utara, Medan, Indonesia

Industrial Engineering Faculty, Universitas Sumatera Utara, Medan, Indonesia

Public Health Faculty, Universitas Sumatera Utara, Medan, Indonesia

Keywords: Patient, Physician's Behavior, Therapeutic Communication.

Abstract: The physician's behavior in therapeutic communication is the process of the physician’s interaction with each

patient with the aim of assisting patients to feels comfortable and not afraid to express their feelings and

thoughts at the beginning of the examination. However, health services provided by a physician, do not match

patient expectations. Therefore, this study wants to find out the ideal therapeutic communication behavior of

physicians. As a result those physicians can meet the needs and expectations of patients. This qualitative study

was conducted at the Teaching Hospital in Medan in 2019. Research using in-depth interviews with 19

patients who were satisfied with the physician's therapeutic communication as data collection. Analysis of

interview data using thematically inductive analysis. The results revealed the physician's behavior in

therapeutic communication based on the patient's perspective was that the physician invites the patient or the

patient's family to joke (pleasantry) and the physician does not discriminate patients based on their level of

education (fairness). The physician's behavior in therapeutic communication based on the patient's perspective

is that the physician's pleasantry and fairness, so the patient experiences well received.

1 INTRODUCTION

The physician’s behavior in therapeutic

communication is the process of the physician’s

interaction with each patient with the aim of helping

patients feels comfortable and not afraid to express

their feelings and thoughts at the beginning of the

examination. The therapeutic communication step of

the physician is that the physician makes preparations

before the meeting. When meeting with patients,

physician welcome patients, talk to them, listen

actively, explain, and discuss stages of treatment.

Therapeutic communication is closed by evaluating

the effectiveness of communication (Lalongkoe and

Edison, 2014; Mardjikoen, et al., 2015; Claramita, et

al., 2016; Erlina, 2016; Ganiem, 2018).

Ideally, a physician must be confidence in his own

abilities, feel what patient feel, underlying his actions

with human essential nature, personal, honest,

appreciate, and accurate. Patients expect

their physicians to be competent clinically treating

patients. In order to treat patients, physicians must

be able to act professionally, respectfully, politely

and sincerely when with patients, interested in

hearing patients' stories, having effective

communication skills, both verbally, in writing, and

non-verbal. Patients have a need to understand and

understand their health, and then are offered hope for

recovery (Ali, et al., 2006; Bendapudi, et al.,

2006; Lypson, et al., 2013; Bressan, et al.,

2017; Ganiem, 2018).

However, several studies in Medan (Panggabean,

2015; Syafitri, 2016; Anonymous, 2018; Ningsih,

2018) show that physicians do not give information

needed by patients, are less able to foster confidence

in patients, give less attention to patients, such as not

handling the patient's complaints quickly and

appropriately, and not understanding the patient's

needs and expectations. Therefore this study wants to

find out the ideal therapeutic communication

behavior of physicians, so that physicians can meet

the needs and expectations of patients.

It's just that not all patients want to express their

feelings openly to physicians in consultation. Patients

260

Lubis, A., Nasution, H., Zulfendri, . and Juanita, .

The Physician’s Behavior in Therapeutic Communication based on Patient Perspective in Hospital Education Medan City.

DOI: 10.5220/0010017702600263

In Proceedings of the 3rd International Conference on Social and Political Development (ICOSOP 3 2019) - Social Engineering Governance for the People, Technology and Infrastructure in

Revolution Industry 4.0, pages 260-263

ISBN: 978-989-758-472-5

feel ashamed and afraid if the disease is known to

others, so physicians do not know the feelings,

thoughts, needs, and expectations of patients to the

physicians (Lalongkoe and Edison,

2014; Mardjikoen, et al., 2015; Claramita, et al.,

2016). Therefore, to find out the therapeutic

communication behavior of physicians in this study

was taken from the perspective of the patient alone.

Informants in this study are patients who are

satisfied with the therapeutic communication

behavior of the physicians in the hospital. This is

because patients who are satisfied with the

therapeutic communication behavior of

the physician feel the reality is greater than the

patient's expectations before meeting with

the physician. This reality is beyond the expectations

of these patients will be ideal expectations for the

therapeutic communication behavior of physicians.

The ideal expectation for physician’s therapeutic

communication behavior is what patients want

the physician to do with excellence so that

therapeutic communication can run more effectively

and efficiently (Thompson and Sunol,

1995; Sangadji and Sopiah, 2013; Willis, et al.,

2016).

2 METHOD

This research was conducted at the Teaching Hospital

in Medan in 2019. The selected hospital was a

teaching hospital, because the results of this study

could be used by physicians who are also lecturers at

the hospital as an example for medical students about

therapeutic communication behavior ideal. The

research method used is qualitative research in order

to obtain an in-depth understanding of the ideal

therapeutic communication behavior based on the

patient's perspective. Informants were 19 patients

who were satisfied with the therapeutic

communication behavior of the physicians from 63

patients who had received therapeutic

communication from the physician. Informants are

obtained incidentally. Informants were interviewed in

depth using sheets containing questions related to the

therapeutic communication of physicians who deal

directly with patients (physician welcome patients,

talk to them, listen actively, explain, discuss stages of

treatment, and evaluate effective communication)

openly. Interview data were analyzed using thematic

analysis inductively, ie themes that emerge outside

existing theories (Boyatzis in Poerwandari, 2017).

3 RESULT AND DISCUSSION

The ideal hope for physician’s therapeutic

communication behavior is what the patient wants the

physician to do with excellence so that therapeutic

communication can run effectively and efficiently.

However, high patient expectations for the ideal

physician therapeutic communication behavior cause

patient dissatisfaction (Thompson and Sunol, 1995;

Willis, et al., 2016). This has led to 63 patients who

received therapeutic communication behavior; only

19 were satisfied with the physician's therapeutic

communication behavior.

The analysis results, from the six steps of the

physician's therapeutic communication dealing

directly with patients, only the first step when the

physician welcomes patients whose themes appear

outside the existing theory. When doctors welcome

patients with excellence, it can make patients feel

well received by doctors. This patient's feeling is one

indicator of the effectiveness of therapeutic

communication carried out by doctors (Ganiem,

2018). Here are the results of the data analysis.

Of the 19 patients who were satisfied with the

physician's therapeutic communication, only 2 person

raised a theme that emerged outside the first step

theory when the physician welcomed the patient, the

physician took the patient or patient's family to joke

and (pleasantry) and the physician does not

discriminate patients based on their level of education

(fairness). The following is an excerpt from an in-

depth interview with the informant.

"Physician joke with patients so patients are

entertained"

"Even though patients only have a junior high

school level, there is no hope of a difference in

treatment"

The use of jokes or humor when welcoming

patients will cut the tension and pain felt by the

patient. The use of jokes or humor can also build

closeness between doctors and patients, thereby

increasing the doctor's success in helping patients feel

comfortable expressing their feelings and thoughts at

the beginning of the examination. But the use of jokes

or humor must also be done carefully and pay

attention to the limits of values and norms, so as not

to offend the patient or the patient's family. Even a

smile in an inappropriate situation can also offend the

patient and the patient feels the doctor does not

empathize with him (Berger, et al., 2004; Pramujiono,

2008; Lalongkoe and Edison, 2014; Wild, 2017;

Ganiem, 2018).

While the theme of this level of education does

not exist in the therapeutic communication pattern of

The Physician’s Behavior in Therapeutic Communication based on Patient Perspective in Hospital Education Medan City

261

physician based on the opinions of some experts

(Lalongkoe and Edison, 2014; Mardjikoen, et al.,

2015; Claramita, et al., 2016; Ganiem, 2018) but there

are factors which influences therapeutic

communication from Lalongkoe and Edison (2014).

When patients have an inadequate educational

background and knowledge, physician use words and

language that are easily understood, understood and

digested by patients, while patients have adequate

educational background and knowledge, physicians

use words and language that are appropriate so the

patient does not feel dictated or patronized. This is

contrary to the wishes of the informants who do not

want to be differentiated based on their level of

education. Therefore, although this is an important

aspect for physicians to consider when

communicating with patients, do not let this offend

the patient.

However, if the results of this study are applied in

a hospital and become a minimum standard of patient

expectations, it will be more difficult for the hospital

to satisfy the same patient when the patient comes

back to the hospital. Therefore, the results of this

study can be the highest standard that can be achieved

by a physician when communicating with patients,

not the minimum standard that must be achieved by a

physician. However, if the patient forgets this ideal

expectation, the hospital can use this expectation

standard and have the same impact repeatedly when

the patient comes back, ie the patient is satisfied with

the therapeutic communication behavior of the

physician every time the patient comes to the hospital

(Rust and Oliver, 2000).

4 CONCLUSION

Therefore, the physician's behavior in therapeutic

communication based on the patient's perspective was

that the physician invites the patient or the patient's

family to joke (pleasantry) and the physician does not

discriminate patients based on their level of education

(fairness).

Physicians and hospitals can use this patient's

expectations as the highest standard that physicians

can meet when communicating with patients. The

lecturer can make this patient's hope an example for

medical students about the ideal therapeutic

communication behavior. If the physician performs

with excellence of these two things, then the patient

will feel well received by the doctor at the beginning

of the examination.

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