Case Management

Be assertive when communicating with physicians

Case Management Monthly, March 1, 2011

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Directly asking the physician, “Why are you keeping the patient here another day?” may come off as critical, and physicians don’t respond well when their authority is threatened, says Ronald Hirsch, MD, FACP, medical director of case management at Sherman Hospital in Elgin, IL..

As physicians, “we have been taught to be decision-makers. When a patient’s life is on the line, we make snap judgments that could be life or death. When someone tells us our decision is wrong, many take it quite personally,” Hirsch explains.

Instead, case managers should ask questions in a way that puts the physician in the role of an educator, says Stefani Daniels, RN, MSNA, CMAC, ACM, managing partner at Phoenix Medical Management, Inc., in Pompano Beach, FL. “Doctors love to teach,” she says. 

Using the phrase “help me understand” is a good way to compel the physician to think about the situation without threatening his or her authority, Daniels says. Also, try to ask open-response questions to encourage conversation. For example, the previous question about keeping the patient an extra day could be changed to, “Help me understand what you are trying to accomplish by keeping the patient here another day. Maybe I can help expedite the situation.”

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Case Management Monthly.

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