Context: Healthcare practitioners are rarely, if ever taught the skills of negotiating with a patient/family in a medical setting. There appears to be a “belief,” that these skills are innate, practiced or learned in training programs or gained in actual medical practice. Yet, evidence suggests this is not the case. Reality dictates that a patient/caregiver may not always agree with physician recommendations.
Methods: Based on literature and research, a practical framework is described which outlines the advantages of structured, and phased negotiations.
Objective: To describe the phases, as a guide to achieving treatment success including: Convening, Opening, Communication, Negotiation and Closing.
Results: Due to misunderstandings, level of knowledge, emotional state, etc., a patient/family may refuse treatment, procedures or surgeries. Greater success can be achieved if the approach is organized, stepwise, collaborative and detailed.
Conclusion: A physician must negotiate treatments that are understood, meaningful, and acceptable. Having a formalized basis of interaction in a medical environment, will ultimately lead to treatment success. Through this prescribed methodology, the clinician can prepare and set goals, initiate and carry out interactions effectively, exchange and refine information, bargain and move toward closure, overcome obstacles and create agreement.
Alan L. Nager