Written
and prepared by Professor Omar Hasan Kasule Sr.
Communication is fundamental to good
medicine, the way doctors communicate can have long term outcome benefits[1];
for example Effective doctor communication reduces pre-operative anxiety and
increases the patient’s satisfaction[2]. Good doctor patient communication
increased elderly patient use of free drug samples[3].
Experience shows that doctor patient
communication is not as effective as it should be. An Indonesian study revealed
several problems in doctor-patient communication: the doctor patient relation
was not participatory and doctors tended to be paternalistic[4]. Analysis of a
videotape of an ophthalmology consultation revealed several negative
communication modes: the interview was physician centered with physicians
speaking 70% of the words, asking closed-ended questions that restricted the
patient's contribution to "yes/no" or brief responses, and failing to
identify patients who had missed doses of medication[5]. Research showed a
communication gap between patients and gastroenterologists regarding the
severity of symptoms and the nature of the functional diagnosis[6].
Communication between doctors and stroke victims was poor with negative
consequences on disease management[7]. A need for more training in
communication was expressed for radiologists[8]. Doctors and their patients
have different perceptions of communication skills of doctors during interviews[9].
Gender, socio-economic status, and
intellectual ability affect communication effectiveness. A literature review
suggested that gender dyads affected interview length and content for example a
female/female dyad has longer interview time. Doctor patient discussion of side
effects of drug was affected by racial and income differences[10]. People with intellectual disabilities require
special approaches to ensure effective communication for example physical
examination has to be demonstrated before it is discussed[11].
Modern information and communication
technology has been introduced in doctor patient communication with variable
outcomes. Electronic medical records have both negative and positive effects on
doctor patient communication: better information integration and processing but
with impaired patient-centeredness[12]. Use of computers in doctor-patient
interaction reduces eye contact, verbal and non-verbal contact[13]. Social
media mediate and improve communication between patients and doctors[14].
Patients who looked up cancer related information on the internet has more
effective communication with their doctors[15]. Health assessment
questionnaires improve doctor patient communication[16].
A patient self- assessment tool can
be used to assess doctor patient communication[17]. A 2-way communication check
list improved doctor-patient communication[18]. Quantifying word use by
patients and doctors can help in research to improve communication[19].
Narrative medicine is an expansion
and improvement on the normal communication being a patient-centered holistic
approach to talking to and listening to the patient[20]. Three factors were
identified to improve communication: two-way communication, biopsychosocial
content and nonverbal communication[21].
REFERENCES
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[2]
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communication, knowledge, and question prompt lists in reducing preoperative
anxiety: a randomized control study. Asian J Surg. 2011 Oct;34(4):175-80..
[3]
Gellad WF, Huskamp HA, Li A, Zhang Y, Safran DG, Donohue JM. Use of
prescription drug samples and patient assistance programs, and the role of
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2011 Jul 13.
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J Health Commun. 2010 Sep;15(6):590-602.
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[21]
Singapore Med J. 2011 Oct;52(10):720-5.
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