S5 - E23.3 - From The EASL Congress: Improving The Physician-Patient Dialogue

Surfing the MASH Tsunami

Co-chairs Shira Zelber-Sagi and Mike Betel and panelists Tom Marjot and José Willemse, all from the EASL Congress session "Patient Experiences in Clinical Settings," join Louise Campbell to discuss strategies and questioning styles that can improve the dynamic of the physician-patient consult.
This conversation starts with Tom stating that having multidisciplinary treatment teams would provide tremendous benefits in terms of being prepared for patients and fully responsive to the issues they are likely to raise. Jose agrees but adds that many countries have only a few nurses and no ability to create these kinds of teams.
Shira states that every physician should learn the principles of motivational interviewing. The key to this is asking open questions that allow the patient to respond fully without feeling judged or steered in a specific direction. This enables the patient to share unhealthy behaviors, which they might not do if the physician admonished them in advance. Tom agrees with the positive tone, saying that so much of the physician's role is all about trying to enthuse the patient to take control of lifestyle factors.
Along a similar theme, Mike notes the importance of tailoring care and questions to the individual patient. He points out that while 10,000 steps/day might be a goal, for some patients, it will feel so unattainable as to be demoralizing. Shira points out that an open question would start by asking the patient what goal is reasonable, and Jose follows by sharing an example of a patient who "hated" all exercise. José found a way to motivate the patient with simple, timely reminders that this was for the liver, and that the liver would be appreciative. Louise adds that changes in activity if the patient can define them as "fun."