Rome Foundation — AGA Institute Communication
Skills Workshop
Improving the Medical Interview and the Physician Patient Relationship
with Patients Having Functional GI Disorders
June 8 – 9, 2012
Chapel Hill, NC
Chapel Hill, NC
Friday Agenda — Presentations
Orientation (Rooker, Bach, Drossman)
Content Session (Chey, Chang, Drossman, Halpert)
- Functional - What's in a Name? - Douglas A. Drossman, MD - 39 minutes
Dr. Drossman discusses historical and philosophical aspects of the FGIDs, problems with terminology, functional-organic dichotomy and need for a more biopsychosocial approach as related to FGID diagnosis and treatment. - Pathophysiology of IBS and Common FGIDs - Lin Chang, MD - 20 minutes
Dr. Chang focuses on IBS pathophysiology while addressing some physiological aspects of Functional Dyspepsia and constipation. - Diagnostic Evaluation - William D. Chey, MD - 19 minutes
Dr. Chey discusses diagnostic criteria for IBS, FD, constipation, and evidence based cost - effective evaluation (uses Rome Algorithms). - IBS Treatments Directed at the Bowel - William D. Chey, MD - 20 minutes
Dr. Chey discusses current and upcoming medications. - Centrally Targeted Treatments - Douglas A. Drossman, MD - 18 minutes
Dr. Drossman discusses psychotropics and behavioral treatments. - Panel Discussion - Lin Chang, MD, moderator - 20 minutes
Introduction to the Process of Care (Drossman and Halpert)
- Understanding and Managing the Patient with Refractory GI Pain - Douglas A. Drossman, MD
- 17 minutes
Dr. Drossman discusses the clinical, pathophysiological and management aspects of patients with severe functional GI pain utilizing psychological principles and the use of centrally acting agents. - The Patient - Albena Halpert, MD - 32 minutes
Dr. Halpert discusses the patient's needs and expectation, the meaning of illness schema, the influence of cultural factors, and ways to understand, engage and address patient's expectations in clinical care.
Dinner - Guest Speaker (Ray Mis)
- Guest Speaker - Ray Mis, MD - 36 minutes
Dr. Mis is a highly respected gastroenterologist who gives motivational lectures relating to how he has adapted and learned with visual and hearing impairments to work with his patients.
Saturday Agenda — Workshops and Small Group Training
Morning Session
- Simulated Interview Demonstration of Patient and her Husband
- Douglas A. Drossman, MD, Albena Halpert, MD, Davis Stillson - 17 minutes
In this video Dr. Drossman interviews a simulated patient, Ms. Smith (played by Dr. Halpert) who has IBS and her husband. The members of the audience created this scenario where the husband is seen as "intrusive" to the interview process. Dr. Drossman demonstrates how he would handle this challenging interview situation and also called on the audience to make comments and suggestions. - Facilitated Small Group Discussion of a Difficult Clinical Interaction - 18 minutes
This small group session involved a challenging clinical interaction presentation by a gastroenterologist. He discussed a patient who presented to his office in an angry and somewhat threatening fashion. The facilitated discussion that ensues is different from a typical case presentation since the focus is on personal reactions, thoughts and feelings. This is similar to a "Balint Group" where the participants can ask question and offer suggestions to help increase understanding of the issues and to help the presenter improve his interactions in the future. - Interviews with Two Patients having IBS - Albena Halpert, MD - 22 minutes
Dr. Albena Halpert interviews two patients with IBS about their symptom history, their interactions with physicians and the impact of the illness on their lives. In particular we learn about what factors enhanced the patient physician relationship. Several key recommendations are also made as a way to move on in their lives while adapting to the illness.
Afternoon Session
- Communication from a Multicultural Context - Saypol, Chang, Halpert, Aderoju, Drossman
This session includes interactions relating to patients from different countries thus providing a cross-cultural context in the area of communication. Patients included those from Nigeria, Mexico and Russia. -
Facilitated Role-plays - Drossman/Chang or Drossman/Chey or Halpert/Chang, or Halpert/Chey
Role Plays done in 2 smaller groups - The audience was broken into doctor-patient pairs. Each pair had the opportunity to play a patient having a medical problem with one vignette and a doctor interviewing his/her partner as a patient for the other vignette. Information gained from the role-plays was later communicated to the group.