Influential Role of Communication Skills for a Physician Assistant

The Physician Assistant (PA) profession communicates knowledge inside and outside of their community specifically by using signs, symbols, and semiotic rules to achieve a mutual understanding with the particular person or group of people. Some duties of PAs are to examine patients, order diagnostic tests, and prescribe medicine. The PAs interpersonal and communication skills encompass many professional aspects within collegial relationships and patients and their families. These skills should demonstrate a compelling sense of interchangeable information to the patient and their families. In an interview conducted with Kara Benner a nurse employed at Michigan Medicine in the medical/surgical unit, this profession similar to a PA, will allow the reader to identify experience within the area of those professions to identify the level of professional used when communicating.

Communication is used in many different ways and by many different people. Communication is an essential skill to a physician assistant, a PA must be able to proficiently communicate information to their colleagues, but also their patients. To well communicate information to the patient, a PA must be able to interchange that knowledge in terms that the patient is confident with and understands. According to the School of Medicine Physician Assistant Program article, Physician assistants are expected to:

• Use effective listening, nonverbal, explanatory, questioning, and writing skills to elicit and provide information
• Appropriately adapt communication style and messages to the context of the individual patient interaction.
• Work effectively with physicians and other health care professionals as a member or leader of a health care team or other professional groups
• Apply an understanding of human behavior
• Demonstrate emotional resilience and stability, adaptability, flexibility, and tolerance of ambiguity and anxiety
• Accurately and adequately document and record information regarding the care process for medical, legal, quality, and financial purposes.

This profession encompasses various communication skills because by communicating, a PA is able to create an ethical relationship with patients and colleagues. Several important aspects that through communication patient care is enhanced is by providing information to the patient in a way they will comprehend and also includes, relationship building to ensure trust and supportive communication in cases where the patient is feeling emotionally distressed. Attaining these skills will prepare you for the PA profession and will help you gain insight on how to communicate within your profession and outsiders.

Communication is not only important as a PA but other professions and disciplinaries. Communication is a method of exchanging mutual understandings and being able to express yourself whether it be in a way a professional way or not. Communicating with a colleague is as much important as it is for PAs to communicate with their patients. The quality of communication that a PA has links with how well their job satisfies them. In Jennifer Anne Hohman’s article “The Importance of Communication in Your PA Career”, she wrote, “when communication at work is an issue, a key question to ask is whether you are in a toxic environment driven by hostile personalities. If you are — get out.” Her article suggests ways to improve communication at work as it provides a greater connection to colleagues as well as patients. In my interview Kara mentioned similar points to Hohman. She agreed that communication should not only be narrowed between the patient and their provider, but also within colleagues. Kara mentioned that in her line of work nurses are known for “eating their young.” This can be defined by how older/more experienced nurses can be hard on younger/newer nurses. For nurses and PAs this is an obvious form of intimidation which rises a lack of communication. With this being said communication at work doesn’t have to be something added to your list of struggles instead you could find a way to improve these misunderstandings and remember where you stand in place.

A principle of the PA profession includes confidentiality between the patient and the care provider. This affects the way a PA is able to communicate with others. When a patient is assured their privacy is protected it allows them to trust their care provider and communicate their medical problems furthermore. This also generates the patient to be more involved with their health issues regarding decisions, treatment, and adjustments. A big example in terms of patient confidentiality is when an adolescent in involved. There must be a balance between the information discussed with the patient (the adolescent) and the patient’s family. Though the patient is not old enough to make their own health decisions the PA should respect what they wish to be shared with their family; taking this into account the PA is able to restrain sharing information to the family to a certain degree about the adolescent’s health. Kara explained the process in which one can obtain information is by knowing the patients password; “If a parent calls asking about their child we ask them for a password which they will have told us on admission. This password will be in their chart. If they know the password they are allowed to get medical information about the patient. If not, we technically can’t even acknowledge that we are taking care of them.” The PA should be aware of who they communicate with about their patients and what people are around; this includes electronic, written, and verbal communication. It is unethical and illegal for a PA to violate patient confidentiality.

What about communicating with a patient who is very sick? Alike other professions PAs must provide compassion where patients are near the end of life. “PAs should provide patients with the opportunity to plan for end of life care. Advance directives, living wills, durable power of attorney, and organ donation should be discussed during routine patient visits.” (AAPA 2013) PAs should assure the patient that they will be cared for to an extent and they will not be abandoned. Using appropriate measures PAs should communicate patient progress and what to expect. When asked to describe a time where she had to communicate with a terminally ill patient Kara said, “I think you just have to take your time when talking and choose your words wisely.” When consulting treatment PAs must inform the patient to discontinue futile treatment and assure the patient understands this alternative. If it comes to it, a PA is not entitled to withdraw from life support, instead, the PA must communicate with the supervising physician and acquire an agreement in line with the health care institution policies.

A more unique form of communication for a PA is through an interpreter. When a patient does not fluently speak the language a PA knows it leads to a poor quality consultation. Even though an interpreter is recommended, if language becomes a barrier, communicating through an interpreter can be difficult. Some people wish to use a family member as their interpreter, but because professional interpreters have the ability to translate medical terminology, family interpreters are not preferred. From Kara’s experience communicating through an interpreter has been easy, but sometimes must rely on a family member in cases of emergency where there isn't time to call an interpreter. According to Emina Hadziabdic’s, Björn Albin’s, Kristiina Heikkilä’s, and Katarina Hjelm’s article “Healthcare staffs perceptions of using interpreters: a qualitative study” their study showed that “having a face-to-face, professional, trained interpreter, with a good knowledge of both languages and of medical terminology, translating literally and objectively, was perceived positively.” Their research concluded that the majority of healthcare professions preferred communicating with a patient using a professional interpreter if they were required.

Communicating information presented through the medical context can be difficult to exchange in a setting that family members and patients understand. Effective communication between PAs and their patients has resulted in greater patient satisfaction. The impact that results from adequate communication reveals that communication is an important skill that creates a better outcome within patients and providers. Inadequate communicate in the workplace could bring an unwanted situation where a PA may not feel comfortable. One can communicate through an interpreter by phone or in person if needed. Because communication is an essential skill to the PA profession they must also take into account that patient confidentiality is crucial. If patient confidentiality is violated it dishonors the trust built into the provider and the patients. In my interview with Kara Benner she answered a few questions of mine and helped me understand a few concepts in the different ways one should communicate. The questions were narrowed down specifically relating to the research I found and much alike to the observations of experience from different articles I read.