Medical Communication Skills - The Doctor Patient Relationship - National Health Care Careers

Carefully honed medical communication skills takes center stage in the doctor patient relationship. Learn why this impacts the quality of healthcare and what you should do about it.

Almost any aspiring doctor in his first year of medical school, already knows a great deal more than the rest of the public about health care. From looking at a chest x-ray and diagnosing a heart complication, to performing surgical operations in an emergency situation, a first year medical student commands a diverse set of complex skills.

What those aspiring doctors often lack however, is the all important ability to truly connect with patients. Often both medical students and seasoned doctors share the same short coming, where the lack of solid medical communication skills impedes the doctor patient relationship.

The culprit: limited contact with the healthcare system. Most any doctor, has yet to find herself in a position where she has had to deal with a detached doctor describing a diagnosis in a matter-of-fact tone, or submit to treatments she doesn't understand. Many have yet to even experience the anxiety of a grueling wait at a doctor's office or an emergency room.

This often does not bode well for the doctor patient relationship and seriously hampers medical communication skills, because the doctor doesn't understand what it's like to “be the patient.”

Top Medical Schools Put Medical Communication Skills Center Stage

We have all heard about the near insanity of medical school and subsequent residencies. Indeed, if you are a doctor or aspiring to that goal, you know the experience first hand. In today's healthcare system, being a patient, especially a patient fighting a protracted disease, proves far more testing.

Medical schools used to place little emphasis on teaching medical communication skills in a meaningful way and offered an even less opportunity to learn the things that impact the doctor patient relationship. Often medical schools still operate from principles dating back to 1910.

At many medical schools that is changing. Now, medical students might find themselves seeing patients and accompanying those patients on visits with specialists and other physician's as they battle prolonged illnesses. Why? To learn what happens as those patients encounter the healthcare system.

It's a crash course of sorts with aspiring doctors experiencing first hand the barriers erected by ineffective medical communication skills that severely limit the doctor patient relationship. Those aspiring doctors get to see first hand the bureaucracy of the modern system, with the endless stream of nameless white coats, language barriers and confusing treatments just to name a few.

How students learn effective medical communications skills that bolster the doctor patient relationship

It took a while, but over time educators realized genuine “empathy” was a missing component in both the education of the potential medical doctor and as well, an important characteristic of quality healthcare.
In a bid to dampen the cold bureaucracy, to build medical communication skills and redefine the doctor patient relationship, in the late 1990's, medical schools such as Harvard University and the University of Pennsylvania began incorporating a partnership of sorts into the clinical experience, by accompanying patients regularly to healthcare appointments and learning how those patients have to navigate the healthcare system.

The objective: to learn why patients hold the keys to understanding the dissatisfaction with the modern healthcare system. Aspiring doctors learn exactly why it is important to listen to patients, such as when the patient is explaining why he didn't take his medication or when he needs to vent about waiting for hours on end to see the doctor. They key is to listen, understand and acknowledge how the patient feels; to show genuine empathy by experiencing the realities first hand.

The previous system of clinical experience, in stark contrast, saw aspiring doctors run through multiple 6-week rotations in various specialties areas of medicine. Typically student doctors would meet patients as those patients were admitted into that area of the hospital, but the relationship ended upon moving to another ward or discharged, with only brief interactions in between while on rounds that serviced multiple patients in the ward.

How the system encourages ineffective medical communication skills and hurts the doctor patient relationship

Healthcare has evolved with such a degree of complexity that today a patient is seen by multiple specialists and doctors, each with his own expertise on a specific biological condition or functioning. This means patients are typically referred multiple times and in hospitals, find themselves transferred between multiple wards in a bid to effectively treat them with the best modern medicine has to offer. This combined with the shortages of staff and the doctors ever increasing workload, leaves very little time for meaningful patient interaction. The system itself is designed as such, that doctors often don't have a concise view of the big picture, but only a narrow view of their part in the patients treatment. There is very little time to forge the doctor patient relationship or even attempt to utilize effective medical communication skills.

While patient-centered care is as ancient as HMO's, the philosophy comes across as rhetorical. In practice, the theory simply falls apart. Setting ethics aside, the bottom line is that doctors feel the ever increasing pressure to work for the bottom-line. The fact is, no matter how much an aspiring doctor is hammered with statements such as “Listen to your patients” or “Show your patients empathy,” none of it really makes much a difference if the doctor has no idea how to accomplish this in a short two-minute visit with the patient, nor if they understand the issues the patients are dealing with.

Learning how to put effective medical communication skills to work and resurrect the doctor patient relationship

The future of the doctor patient relationship is one that will involve doctors leveraging a more Eastern philosophy towards patient interaction, whereas the doctor learns to view the patient from a holistic perspective rather than focusing on a set of symptoms.

As doctors become inoculated against patient concerns as they deal with the realities of a high pressure healthcare system, educators across the nation are regularly implementing creative strategies to help aspiring doctors better understand their patients.

In some cases, medical students may attend to home visits or have lunch with patients, giving them the opportunity to forge medical communications skills on a tight schedule. In other cases doctors may find themselves assisting patient at appointments to fill out insurance forms or even navigate the medicare system when a problem arises with claims or treatments.

The objective: to open up honest dialogue between patient and doctor. Oftentimes, patients withhold information such as community hearsay that prevents them from taking required medication or in other cases a patient may value peace of mind over prolonged treatment, even if it means death. By better understanding the patient, a doctor is in a much better position to provide the right healthcare service needed by the patient.

The bottom-line is as a doctor, the focus must put aside feelings of guilt or sorrow about the patients conditions and take up the idea of fixing the patient. In some cases this might mean attending to the illness proactively to eradicate it; but, in other cases this might mean helping the patient gain a measure of quality life despite a terminal illness. How the doctor moves forward should begin with understanding the patients perspective on his situation.

Tips

First encounters with patients are critical. In the first few moments of that encounter, a patient will decide if he is comfortable with you. You should prepare to know your patient before meeting with them. Don't fumble through the patients files in an attempt to get your information together during that meeting. Prepare before you meet the patient, make eye contact, set the patient at ease and build rapport, take a seat and let the patient tell his story.

Warnings

Non-verbal cues are just as important as what you have to say to the patient. Don't lean back in your chair, stand as an imposing figure or cross your arms. These are all signs that say you know what's best and are not really interested in what the patient has to say. Such non-verbal cues will close the opportunity for open communication, thereby negatively influencing the doctor patient relationship.

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