Communication for Doctors

Description:
What Makes a Good Health Care System? examines the various assumptions that underpin the different views of what makes a good health care system. The national systems in the UK, Australia and Canada are thoroughly examined. Each country has a different view of what a good health care system is trying to achieve, and the book elucidates these by highlighting key policy documents and comments from key stakeholders. Case studies emphasise the diverse needs and expectations of individuals, examining and comparing concepts of health needs, quality as a measure of ‘good-ness’ and the various ideas on Gold Standards. This book will be valuable reading for all healthcare managers and clinicians with management responsibilities, as well as policy makers and shapers and all those with a general interest in health.

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So said the great clinician Sir William Osler in the early part of the last century. And even if that piece of advice was offered tongue in cheek, today’s physicians would quickly face opprobrium – if not a lawsuit – if they followed it.

As a matter of fact, litigation in medicine often has more to do with breakdown in communication than with clinical malfeasance. As Levinson et al. point out in the Journal of the American Medical Association (277 (7): 553): “Significant differences in communication behaviors of no-claims and claims physicians were identified in primary care physicians.” General internists and family doctors who spend more time with patients were more likely, according to the article, to educate them, to elicit information and to listen to it, and were less likely to face litigation.

And Maguire and Pitkeathly noted in the British Medical Journal (325: 697-700) that “good doctors communicate effectively with patients – they identify patients’ problems more accurately, and patients are more satisfied with the care they receive.” Moreover, the authors noted, doctors with good communication skills also have greater job satisfaction and less work stress.

It was with these kinds of thoughts in mind that I wrote Paging Doctors, a book largely about communication issues in healthcare – speaking, writing, reading, listening – and about the use, and misuse, of language in medicine. Out of that book came a newsletter, Medical Practice Communicator, which for eight years was sponsored by an enlightened medical malpractice insurance company that made it available to its 25 000 insured physicians.

While most of the pieces collected here are from that newsletter, some, especially the interview with Norman Cousins and the article on medicine and the English language, had an earlier life in Paging Doctors … and an even prior iteration in the pages of the Canadian Medical Association Journal, for which I wrote some 200 articles, editorials, reviews and interviews.

The medical director of that company, Dr Robert Pendrak, was the visionary who saw that physicians who communicate effectively are less likely to be sued. Since this book, Communication for Doctors, contains many of the articles that appeared in Medical Practice Communicator, I should like also to acknowledge here the newsletter’s vigilant and talented copy-editor and proofreader, Edith Schwager, author of Medical English Usage and Abusage, and its equally rigorous medical editor, Dr John Gartland, author of Medical Writing and Communicating. Further, I am most grateful for the contributions made by readability consultant, Mark Hochhauser; lawyers Joan Roediger and James Saxton; former scientific editor of the Canadian Medical Association Journal, Dr Peter Morgan; computer and information technology expert, Jonathan Coopersmith; Susan Keane Baker, author of Managing Patient Expectations; Albert Mehl, pediatrician; Julia Schopick, public relations consultant; and Peter Ubel, Director, Health Care Decisions

Program – all of whose work appears, with their permission, in the following pages. Further thanks are due to production editor, Norman Kline, for scanning and pulling together the 66 titles that make up Communication for Doctors, and to my wife, Shelly Wolf, for her project management skills, sage counsel, and unfailing support and encouragement.

All of us associated with Medical Practice Communicator felt that many of its articles were too valuable to the broader international community of medical practitioners to be allowed simply to float into the ether. That is why we have collected the best of them here – to help doctors become not only better communicators, but better doctors.

Table of contents :
Cover
Title
Copyright
Contents
Foreword
Preface
About the editor
List of contributors
Patients are a virtue
What do patients think of doctors as communicators?
Making patients your partners
Thirty ways to make your practice more “patient-friendly”
Eight easy ways to make the medicine go down
Answering questions patients don’t ask
Can your patients read your writing?
How about a Hippocratic Oath for patients?
Hippocrates was right: treat people, not their disease
How non-verbal communication can give patients a sense of connectedness
Empowered patients may have something to teach us
How to communicate with patients who (think they) know more than you do
How to deal with illiterate patients
How to avoid alienating patients
“Take two aspirin and call me in the morning”
Seven ways to build trust with your patients on their first visit
Watch your language
Medicine and the English language
The printed word: encouraging a more coherent view of the world
Writing and speaking painlessly
Who’s for Tennyson? The case for language and literature in medical school
Splitting atoms and infinitives
Making sure your language doesn’t mystify patients
Reforming the language of healthcare
Euphemism in medicine: calling a spade a horticultural implement
Humor in medicine: the whimsy of Richard Gordon
Elevator etiquette: when is communication too effective?
A conversation with Norman Cousins
The future of medical publishing
Physician, heal thyself
Becoming accustomed to public speaking
Do you speak “Medispeak”?
Let’s hear it for sounder listening skills!
Specialty scientific meetings: time for critical review
Recognizing and avoiding non-verbal cues we give our patients
Strategies for not appearing rushed
Doctors can deliver hope as well as facts of prognosis
The doctor patient
The importance of doctors’ “people skills”
The profession’s image: you’re OK, they’re not
What’s wrong with a little “loathsome finery”?
Physicians: an endangered species?
Manners and medicine
Improving physicians’ grades in communication
How to avoid getting kicked by the media donkey
Reading to keep up to date
Are postgraduate courses necessary?
Doctor-to-doctor communication
Controlling the information balloon
Managing your practice
How your staff can make or break your practice
Improving your efficiency by maximizing your time
Technology to enhance your practice
Healthscapes: how physical surroundings influence perceptions of quality
Hiring? Use this checklist
How to handle complaints
How to respond to an angry complaint
How to improve your sign language
A complete, updated and signed history is vital before treatment begins
Making your reception area more welcoming
Minimizing risk
Communication and documentation at the root of growing legal risks
Clean up your documentation: use SOAP
Telephone advice should be documented
The telephone: instrument of the devil or practice enhancer?
Ten tips for effective informed consent discussions
Top ten issues in medical malpractice
You’ve been called as an expert witness: now what?
Terminating the physician-patient relationship
Quiz
Are you a good communicator?
Patient questionnaire
Index