Health care professionals including doctors need to communicate with patients or their parties in their
day to day activities. It is an essential activity of doctors. In the present medical curriculum emphasis has been given to learn communication skill by the future doctors.
How to improve communication between doctors and patients?
Communication difficulties between doctors and patients have been looked at by researchers from several disciplines who have tried to explore why these occur. Mishler, for example, has argued that doctors and patients talk to each other in different voices. The voice of medicine is characterized by medical terminology, objective descriptions of physical symptoms. The voice of patients, on the other hand, is characterized by non-technical terminology about the subjective experience of illness within the context of social relationships and the patient''s everyday world. Typically, doctors have more power than patients to structure the nature of the interaction between them. As a consequence, patients may feel that their voice is overridden, silenced, or stripped of personal meaning and social context. To improve communications between doctors and patients we also need to understand the nature of the decision making that is taking place in the consultation.
Why is good communication important?
The communication skill means ‘better care for our patients''. There is considerable evidence to show that doctors who communicate well with patients are more likely to:
1. Make an accurate, comprehensive diagnosis.
2. Detect emotional distress in patients.
3. Have patients who are satisfied with the care they have received and who are less anxious about their problem.
4. Have patients who agree with and follow the advice given.
In countries where patients are less likely to sue their doctors, patients still express dissatisfaction about how doctors communicate and relate to them.
Can communication skills be learned?
Training to be a doctor involves the acquisition of knowledge, skills and appropriate attitudes. Like many aspects of medical education, it was assumed until fairly recently that students acquire good communication skills and appropriate attitudes by a sort of osmosis-- by observing and modeling their behavior on that of their teachers.
In the 1970''s a series of studies was carried out on medical students during their fourth-year clerkship in psychiatry. The study found that before training, students experienced difficulties in obtaining histories from patients. The difficulties which were highlighted included:
Not obtaining all the necessary information from the patient.
Forgetting to ask about the influence of the patient''s problems on themselves and their family.
Failing to notice and respond to verbal and nonverbal cues from the patient.
Looking bored during the interview.
It was found that the students who had received feedback training were better at communicating with patients.
Patient- Physician communication: Why and How?
Patient-physician communication is an integral part of clinical practice. When done well, such communication produces a therapeutic effect for the patient, as has been validated in controlled studies. Formal training programs have been created to enhance and measure specific communication skills. Many of these efforts, however, focus on medical schools and early postgraduate years and, therefore, remain isolated in academic settings. Thus, the communication skills of the busy physician often remain poorly developed, and the need for established physicians to become better communicants continues. The manner in which a physician communicates information to a patient is as important as the information being communicated. Patients who understand their doctors are more likely to acknowledge health problems, understand their treations, modify their behavior accordingly, and follow their medication schedules.
Why Bother Communicating with patients?
A Reminder about the value of communication From obtaining the patient''s medical history to conveying a treatment plan, the physician''s relationship with his patient is built on effective communication. In these encounters, both verbal and nonverbal forms of communication constitute this essential feature of medical practice.