“Ok, so what you need to do is reduce taking the tablets you have been taking down to once a day and take two of these new tablets three times a day, then come back and see me in two weeks from now. Is that ok?” “Yes, thank you doctor.”
If only life were so simple. “The single biggest problem in communication is the illusion that it has taken place” is the well-used quip from George Bernard Shaw. The words of the American journalist Sydney J Harris are also worth considering: “The two words information and communication are often used interchangeably, but they signify quite different things. Information is giving out, communication is getting through.”
These two quotes help to highlight some of the biggest challenges for the doctor in practice.
“Communication, partnership and teamwork” and “Maintaining Trust” are the third and fourth domains of Good Medical Practice. As a doctor, the ability to effectively interact with others – to ensure that all concerned hear what needs to be heard whilst you demonstrate respect, compassion and commitment to care – has a powerful impact upon patients, carers and colleagues. It is essential for the doctor to “get through” to the patient. It is equally vital for the patient to “get through” to the doctor. A proactive approach to reviewing and enhancing the skills in these domains must therefore be treated as equally important as any other clinical skill.
In our Advanced Patient Communication Skills Course for Doctors we the explore the many factors which come into play to both prevent and distort the messages which are travelling in both directions between doctor and patient. Some patients have lots to say on any subject, while others are reluctant or struggle to share any information. Some are openly emotional and ask lots of questions, while others are reserved, factual and even detached. The pressures of time can mean that the patient has been left waiting, ready to burst forth with descriptions by the time the consultation starts; the doctor on the back foot and trying to get to the crux of the matter while trying to get back on schedule. Missing information, inherent associations and time pressures lead to assumptions being made by both parties – not all of which may be correct.
The good doctor must be capable of managing the patient consultation to ensure that all concerned hear what needs to be heard. Inevitably this is easier in some circumstances than others.
What steps have you taken recently to review and develop your skills in this area?
