Developing Good Communication Skills to Improve Patient Care

Doctor-patient communication

Good communication skills are an extremely important requirement of becoming an effective physician or other health care professional. If you can communicate, explain, teach, express concern and combine that with a generous portion of medical knowledge and professionalism, you will be very successful.


The first and most important communication skill to develop is to become an active listener.

Use non-intimidating body language and eye contact to let your patient know you are listening and understanding their story with concern. Let them ventilate if they are frustrated about something. Allow them to express their concerns about their health. If you listen closely with a trained ear and follow their expressions with your eyes, you will get a much better sense of what's going on with them. Also, if you let them talk for more than 18 seconds (the average time a physician allows the patient to talk before interrupting), and really listen to their symptoms, you may actually be able to make a decent diagnosis.

The second communication skill to attain is to try to remain professional and objective.

That doesn’t mean never to show emotion, but it means that certain emotions must be controlled for the purpose of helping the patient get through a difficult situation whatever that may be. Compassion and concern should always be your foremost expressions. Hold back on your emotions of anger, irritability and impatience. They will get you into trouble that you will have a hard time backing out of. Consciously recognize the inner reaction that a certain situation is arousing in you, try to understand why that is happening, step aside from that inner reaction, think about it objectively, and above all, don’t let your emotions guide what you do or say. Your actions and words always have to be in the best interest of the patient, even if your gut is wrenching inside.


The next communication skill to develop is to always think before you say anything.

Unlike dictating or word processing where you can delete phrases or paragraphs if they don’t sound right, you can’t delete something you’ve said to a patient or family member. You may try to go back and correct it or somehow put it in a better light. However the initial effect of what you have said may not be erasable. It is forever recorded somewhere in the brain of the person you’re talking to and cannot be undone.

Most people are forgiving and understanding and know that everyone can make mistakes in speaking, but they won’t readily accept rudeness, abruptness, poor etiquette or lack of concern from a professional who is supposed to know better.


The fourth communication skill relates to how you discuss the seriousness of a situation.

Be careful about being overly optimistic. Never promise a good result. There is a fine line between healthy reassurance and promoting unrealistic expectations.

By the same token, don’t be overly pessimistic either. This creates excessive and sometimes needless anxiety in patients and families.

It is important to be truthful, however. If the situation is truly bad then you should say so in the most compassionate way that you can. Never leave the patient with the words, “There’s nothing else I can do”. There’s always something you can do, or you can at least offer to be there for the patient to help him/her with things like pain control, etc. if and when it’s needed.

Don't get hung up on statistics. They are good to know, but whatever happens to the individual patient is 100% for him/her no matter what the literature says. You may speak in terms of likelihood that this or that may happen, but it would be cruel to give them a death sentence of 6 months, for example. The truth of the matter is that you don't really know for sure what the course will be for this particular person. If you try to predict it too exactly, you will be wrong most of the time.


The fifth communication skill is to know what not to say.

Never suggest or imply that you may have another agenda other than the welfare of the patient. For example, never indicate to a patient that you don’t want to order a test because you’re trying to reduce health care costs. While this may be a worthwhile goal for society, it should never enter into the discussion you’re having with an individual patient.

Don't discuss your personal life or problems. The patients have enough problems of their own without having to listen to yours. Furthermore, they are probably not interested. When they come to see you, that time is theirs not yours. Try to focus on their concerns, even if you are having a bad day.


This discussion about communication skills should not arouse undue anxiety or stress in you as you deal with patients and families on a day to day basis, mainly because if your true motive is to provide the best care, comfort and compassion as you can for your patients, you won’t have any problem with this. However, It may help to keep these things in the back of your mind, be aware of them; but don’t let them render you non-communicative because you’re afraid you may say something wrong.

If you do mis-speak, correct it right away. If you’ve developed a good relationship with your patient up to this point, it won’t be a problem.

Basically, you want to be “friends” with your patients. You should always try to be on their side and be their advocate as much as possible. There may be times when it’s not possible if that would require you to be untruthful or unethical; but that is extremely rare. Otherwise, always try to be helpful. They will forever be appreciative and will always hold you in high regard for it.

This page was last updated on October 10, 2010.


References:

Health Communication in the 21st Century (adlink) by Wright, et al

The Doctor's Communication Handbook (adlink) by Peter Tate


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