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Coummunication

Good communication skills are an essential component of the doctor-patient relationship.

As outlined by the GMC( http://www.gmc-uk.org/guidance/good_medical_practice/communicate_effectively.asp)

You will always need to communicate effectively and honestly with patients. You also need to communicate well with colleagues within and outside the healthcare team in order to ensure continuity of care and effective treatment for patients. Good communication is also an essential element in the other non-clinical areas

’Poor communication’ has been identified as a significant factor in over a quarter of disciplinary action cases taken by employers against BMA members.

Use clear language: Avoid jargon and tailor your language to your patients’ understanding and information needs. With colleagues, be clear' concise and professional. For doctors that have graduated overseas, or have English as a second language, this can be a challenge.

Be conscious of your non-verbal communication: It is important to maintain eye contact—reading notes or looking at the computer screen may convey negative messages.

Negotiate an agenda: Ask patients what they need from the consultation, and explain what can be covered. Few doctors explain the purpose of the consultation or the time available, and less than one quarter negotiate over treatment.

Establish a dialogue: Determine whether your patient agrees with the diagnosis and management plan. Patients who disagree with the diagnosis probably won’t adhere to the treatment.

Be flexible in your consultation style: Tailor your approach to the individual patient. A more directive style may be appropriate for patients who want less involvement in decision making. A supportive style—listening attentively and asking questions about psychosocial issues—helps facilitate the disclosure of sensitive information.

Provide the information that patients want: Doctors tend to talk too much about drug treatment, whereas patients want to know about causes and the likely diagnosis and prognosis. They want more openness about side effects and advice on how to relieve pain and emotional distress and what they can do for themselves.

Reflect on the outcomes of your interactions with others: Why do some doctors work well and others not so well? Communication difficulties are one of the main reasons that patients complain about doctors. The most common criticism is not about the doctors’ competence but that they have failed to listen or to offer sufficient explanation.

Apologise when communication is poor: Apologising and expressing regret at the distress experienced by a patient or colleagues is not an admission of liability. Ineffective communication is the single largest factor behind litigation by patients. Good communication, including effective apology, can avert or help end conflict, especially litigation. It never does any harm to apologise—for yourself or on behalf of colleagues.

Empathise and listen: Your relationship with the patient and colleagues are vitally important. Empathy is the ability to understand what another person is experiencing and to communicate that understanding to the person.

Mindful practice: This is your ability to observe not only the patient but your own performance during the consultation. Mindful doctors can easily be identified by patients and colleagues—they are present, attentive, curious, and unhindered by preconception.

Establish rapport: Recognition and explicit acknowledgment of the emotional content in your patient’s story is particularly important in establishing rapport. Doctors often respond to emotional cues by offering premature reassurance, explaining away distress as normal, attending to physical aspects only, switching the topic, or “jollying” patients along.

This page was last updated on: 15.06.2018 at 11.27


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