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Hello, my name is Gina Geis and I'm an Attending Neonatologist at Albany Medical Center and Assistant Professor of Pediatrics at Albany Medical College.
This module will address the topics of professionalism, the parent-physician relationship, communication, and the prenatal consult. I have no disclosures or conflicts of interest.
We all know that communication is important in the field of medicine. But there are nuances in the field of neonatology that can make effective communication particularly important and challenging. Communication and professionalism are core concepts within bioethics. And we will address them here, as they pertain to neonatology.
We will identify the key competencies for effective communication. We will define the essential components of professionalism as outlined by the American Board of Pediatrics. We will look at the various ethical principles and how they apply to this area of focus. We will also delve a bit deeper into the prenatal consultation. And examine how the written literature can guide us through this process. We will also look a bit into the parental perspective and identify which elements of communication they deem most important.
Effective Communication.
So we can all agree that communication is important. But why? It's a part of everything we do in medicine. It is the most important and common procedure in medicine. The use of the word procedure is interesting as it applies that there's something performed when we communicate. We will get into this a little more, later in the slides.
Over time, there has been a transition from paternalism to joint decision-making. Effective communication is essential to achieve this partnership. Even though we are jointly making these medical decisions, we still emphasize the importance of autonomy.
Typically, we talk about patient autonomy. But in pediatrics, in most cases, it is the parent that acts as a surrogate for patient autonomy. We assign this role based upon the assumption that the parent has the best understanding of the best interests of their child.
But what about provider autonomy? Provider autonomy states that the medical provider should be able to practice medicine as she or he deems appropriate. Effective communication helps us to uphold both patient and provider autonomy. And promotes the achievement of shared goals of care.
We know that communication influences both patient and provider experience. Patients report greater satisfaction with their healthcare experience when communication was effective. Also, the ability to effectively communicate enhances our satisfaction as providers and improves outcomes.
Finally, we practice in an increasingly complex healthcare system. Effective communication is essential to navigate through these complexities, increase efficiency, and minimize burnout. Effective communication is responsive to the needs of the whole patient and family dynamic. It is essential to the patient-centered and family-centered care, the basic building block of the medical home concept, endorsed by the American Academy of Pediatrics as the cornerstone of care.
You can see that with this definition, there's an emphasis on the patient perspective. In other words, to make communication effective we must make this a bidirectional process. Communication is not only given, but received. There should be a flow back and forth.
In 2008, the American Academy of Pediatrics and the Committee on bioethics released a technical report to guide communication with families and children. In this report, they identified three elements of effective physician, parent, child communication.
12 июл 2024
