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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].


[1] Wallis WM. Communication as fundamental to the Doctor-Patient relationship. Acta Biomed. 2008 Apr;79(1):52-6.  

[2] Lim L, Chow P, Wong CY, Chung A, Chan YH, Wong WK, Soo KC. Doctor-patient 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 doctor-patient communication. J Gen Intern Med. 2011 Dec;26(12):1458-64. Epub 2011 Jul 13.

[4] Claramita M, Utarini A, Soebono H, Van Dalen J, Van der Vleuten C. Doctor-patient communication in a Southeast Asian setting: the conflict between ideal and reality. Adv Health Sci Educ Theory Pract. 2011 Mar;16(1):69-80. Epub 2010 Jul 25.

[5] Ophthalmology. 2009 Dec;116(12):2277-85.e1-3. Epub 2009 Sep 10.  Doctor-patient communication in glaucoma care: analysis of videotaped encounters in community-based office practice. Friedman DS, Hahn SR, Quigley HA, Kotak S, Kim E, Onofrey M, Eagan C, Mardekian J.

[6] Clin Gastroenterol Hepatol. 2009 Nov;7(11):1252-4, 1254.e1-2. Epub 2009 Jul 1. Do we know what patients want? The doctor-patient communication gap in functional gastrointestinal disorders. Collins J, Farrall E, Turnbull DA, Hetzel DJ, Holtmann G, Andrews JM

[7] Neurologia. 2011 Mar;26(2):81-91. Epub 2010 Dec 16.  Sociocultural study on the self-perception of stroke and an analysis of doctor-patient communication. [Article in English, Spanish] Díez-Ascaso O, Martinez-Sánchez P, Fuentes B, Díez-Tejedor E.

[8] Radiol Med. 2012 Apr;117(3):339-53. Epub 2012 Mar 19.  Doctor-patient communication in radiology: a great opportunity for future radiology. Bazzocchi M.

[9] Soc Sci Med. 2010 Mar;70(5):763-8. Epub 2009 Dec 11. Interpersonal perception in the context of doctor-patient relationships: a dyadic analysis of doctor-patient communication. Kenny DA, Veldhuijzen W, Weijden T, Leblanc A, Lockyer J, Légaré F, Campbell C.

[10] Arthritis Rheum. 2007 Dec 15;57(8):1539-45.  Racial/ethnic disparities in patient-reported nonsteroidal antiinflammatory drug (NSAID) risk awareness, patient-doctor NSAID risk communication, and NSAID risk behavior. Fry RB, Ray MN, Cobaugh DJ, Weissman NW, Kiefe CI, Shewchuk RM, Saag KG, Curtis JR, Allison JJ.

[11] BMC Fam Pract. 2009 Dec 17;10:82.  Doctor-patient communication with people with intellectual disability--a qualitative study. Wullink M, Veldhuijzen W, Lantman-de Valk HM, Metsemakers JF, Dinant GJ.

[12] Shachak A, Reis S. The impact of electronic medical records on patient-doctor communication during consultation: a narrative literature review. J Eval Clin Pract. 2009 Aug;15(4):641-9. Epub 2009 Jun 10.

[13] Int J Med Inform. 2012 Jan;81(1):12-28. Epub 2011 Oct 13. Mobile health IT: the effect of user interface and form factor on doctor-patient communication.Alsos OA, Das A, Svanæs D.


Health Commun. 2012;27(1):30-41. Epub 2011 Jul 28. The effect of computer-mediated social support in online communities on patient empowerment and doctor-patient communication. Oh HJ, Lee B.

[15] J Psychosoc Oncol. 2010 Mar;28(2):127-42.  Doctor-patient communication about cancer-related internet information. Bylund CL, Gueguen JA, D'Agostino TA, Li Y, Sonet E.

[16] Bull NYU Hosp Jt Dis. 2010;68(3):223-31. Beyond RAPID3 - practical use of the MDHAQ to improve doctor-patient communication. Pincus T, Yazici Y, Bergman MJ.

[17] Patient Educ Couns. 2010 Nov;81(2):275-314.  A patient self-assessment tool to measure communication behaviors during doctor visits about hypertension. Ashton CM, Holt CL, Wray NP.

[18] Acta Psychiatr Scand. 2008 Oct;118(4):322-6. Epub 2008 Jul 17. Evidence that the Two-Way Communication Checklist identifies patient-doctor needs discordance resulting in better 6-month outcome. van Os J, Triffaux JM.

[19] J Health Commun. 2010 Sep;15(6):590-602.  Quantifying word use to study health literacy in doctor-patient communication. Koch-Weser S, Rudd RE, Dejong W.

[20] Clin Ter. 2011;162(2):91-2. Narrative medicine: the modern communication between patient and doctor. Coaccioli S.

[21] Singapore Med J. 2011 Oct;52(10):720-5.  Working toward the best doctor-patient communication. Neo LF.


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