Laura Landro of the Wall Street Journal wrote an article “The Talking Cure” which appeared today (4/9/13). She makes several good points: 1) 39% of patients feel doctors communicate poorly, 2) better communication improves health and reduces cost and 3) there are ways to help doctors communicate more effectively.
These points are difficult for doctors to accept, especially the 39%. Yet, the data is undeniable; the oracle of Wall Street speaks truth. Although, most physicians do not like to hear such comments from the lay media the message has been communicated well and with empathy.
Many years ago the Iowa Health System had doctors at one clinic participate in a communication study. The patients were told that at the end of the clinic visit they would be given a test about what was wrong with them and what instructions they should follow. A ton of bricks fell on the clinic. The patients all had a pencil and paper and they would not let the doctors leave the exam room until the they had the answers to the impending quiz. After all, the patients did not want the doctor to look bad. The doctors tell the story of the experiment with fond memories and a feeling of gratitude for the lesson in communication. The patients did pass their tests!
The Wall Street Journal article comments on the “4 habits” of good communication for health care providers: 1) create rapport 2) elicit patient views (and listen), 3) demonstrate empathy, and 4) assess patient ability to follow a treatment regimen. It takes a lot of practice to think about the evidence-based practice-guidelines and simultaneously do those 4 things.
Doctors in training generally find video recording of patient interactions both stressful and time consuming. Video-based training takes time away from the operating room and clinic — but is that bad? College communication majors become very comfortable with video training — they see themselves in the video recording and they use the sessions to hone communication skills. Perhaps physician training programs should take a lesson from the department of communications.
Medical knowledge is a package within a wrapper. That wrapper is communication skill which may be as important as the package itself.