Communication is key, says Suneel Dhand
by Suneel Dhand, MD July 18, 2017
There are many different theories out there about the direction that healthcare should go and what we need to be doing in the future. Passions run high, and peoples’ opinions vary wildly. It’s frequently difficult to find agreement on anything. There is, however, one universal truth I’ve found about the everyday practice of medicine, and what constitutes great medical care for any individual in any healthcare system. Having worked in the United Kingdom, Australia, up and down the east coast here in America — and even had experience with medicine in a third world country, India, when relatives have been unwell — the same rule always applies. This is the following: Good communication is at the core of all good medical care, no matter where you are.
Here are three important examples:
1. The doctor-patient interaction. However advanced we become scientifically and technologically, humans will always be humans. We are emotional beings that crave one-on-one personal connection. That sacred doctor-patient interaction, centered around trust, is to be valued and promoted. Doctors frequently need to be good communicators above being highly skilled clinicians. The ability to communicate well with patients and have a deep understanding of human nature, is paramount for any competent physician. We’ve all seen everyday examples of physicians who could quote you any scientific paper from the last decade, yet have no idea how to talk to patients and their families. At the opposite end of the spectrum, is a physician who is terrible clinically (not that it’s ever something to aspire to), yet is highly personable — and their patients love them! While lots of traits that lead people to be good communicators may be innate, there are also many skills that can totally be taught and improved upon through deliberate practice.
2. Organizational and administrative communication. The reality of modern day healthcare is that organizations need to work with all their staff and be as collaborative and open as possible. As soon as mistrust and suspicion has taken hold between administrations and their frontline staff, it’s a very difficult situation to come back from without a major overhaul. It never ceases to surprise me how some very experienced and high-level people can be such poor communicators, and not have insight into the effect their poor choice of words and tone have.
3. Communication between doctors and healthcare facilities. There is a term I use, and have written about previously, called “Too Many Cooks in the Kitchen Syndrome.” This is an all too common occurrence in healthcare settings when a complex (typically elderly) patient with multiple comorbidities, is seen by a large number of different specialists. Communication is lacking between these different doctors, and everything ends up confused and muddled (most of all for the patients and their families). Along the same lines, communication within and between healthcare facilities during transitions of care also still sadly leaves much to be desired. In these situations, nothing beats a concise, good old fashioned face-to-face or telephone conversation between doctors.
We have so much we need to improve upon. As with many things in healthcare, lots of the answers are surprisingly straightforward. They basically rely on talking and communicating more with each other. They do not — as lots of people sadly believe — rely on more computer time, funky expensive apps, or more complex bureaucracy (ironically, many of the issues that doctors, nurses, and patients have right now with healthcare information technology, is the widespread perception that it actually impedes good communication). That’s not to say that technology doesn’t play a crucial role in communicating test results and messages, but where we fall short is often in other simpler ways.
Healthcare is a unique field. It is emotional and personal. For patients, who are being seen at a very low point in their lives, nothing could be more important than being able to communicate with their doctors, and also knowing that their doctors are communicating with each other. For physicians, those moments of one-on-one communication and personal connection are also the most meaningful as well. It’s a field where communication is literally, everything.
Suneel Dhand is an internal medicine physician and author of three books, including Thomas Jefferson: Lessons from a Secret Buddha. He is the founder and director, HealthITImprove, and blogs at his self-titled site, Suneel Dhand. This post appeared in KevinMD.com.