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3 - Communication skills

Kerry J. Breen ,
Stephen M. Cordner ,
Colin J. H. Thomson  and
Vernon D. Plueckhahn
Kerry J. Breen
Affiliation:
National Health and Medical Research Council
Stephen M. Cordner
Affiliation:
Monash University, Victoria
Colin J. H. Thomson
Affiliation:
University of Wollongong, New South Wales
Vernon D. Plueckhahn
Affiliation:
Monash University, Victoria
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Summary

Chapter 1 emphasised how respect for patient autonomy has become more central to the doctor–patient relationship while beneficence has been diminished in importance because of its paternalistic overtones. Effective communication strengthens patient autonomy by enhancing understanding and is essential for good medical practice. It is the means of history taking, obtaining consent for examinations and procedures, and explaining diagnoses and treatment. Effective communicators are able to establish rapport, trust and confidence with patients more easily than ineffective communicators, thereby enhancing the flow of crucial information and increasing the likelihood that advice will be heeded. Effective communication decreases the likelihood of complaints, acrimony or legal action if adverse events occur [2–3]. Good communication skills alone are not sufficient for professional medical practice and must be accompanied by clinical competence, empathy and ethical behaviour. Good communication skills are also a necessary prerequisite if the doctor is to provide effective leadership of the ‘health-care team’.

Effective communication also improves the quality of health care [5–6] and can have a very positive effect on the satisfaction gained from a consultation by both doctor and patient. Breakdowns in communication are the most common basis of patient dissatisfaction. Surveys show that dissatisfied patients criticise their doctor for not listening, for not providing adequate explanations or for appearing disinterested. Satisfied patients perceive their doctor to demonstrate humaneness, understanding, ability to listen without hurrying the patient, and the skill of involving the patient in decision making [7–9].

Type
Chapter
Information
Good Medical Practice
Professionalism, Ethics and Law
 , pp. 33 - 48
Publisher: Cambridge University Press
Print publication year: 2010

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References

Tamblyn, R, Abrahamowicz, M, Dauphinee, D et al. Physician scores on a national clinical skills examination as predictors of complaints to medical regulatory authorities. JAMA 2007; 298: 993–1001.CrossRefGoogle ScholarPubMed
Simpson, M, Buckman, R, Stewart, M, Maguire, P, Lipkin, M, Novack, D et al. Doctor–patient communication: the Toronto consensus statement. BMJ 1991; 303: 1385–7.CrossRefGoogle ScholarPubMed
Levinson, W, Rotor, DL, Mullooly, JP et al. Physician–patient communication. The relationship with malpractice claims among primary care physicians and surgeonsJAMA 1997; 277: 553–9.CrossRefGoogle ScholarPubMed
Laidlaw, TS, Kaufman, DM, Sargeant, J et al. What makes a physician an exemplary communicator with patients. Patient Educ Couns 2007; 68: 153–60.CrossRefGoogle ScholarPubMed
Meryn, S. Improving doctor–patient communication. BMJ 1998; 316: 1922.CrossRefGoogle ScholarPubMed
Stewart, MA. Effective physician–patient communication and health care outcomes: a review. Can Med Assoc J 1995; 152: 1423–33.Google ScholarPubMed
Kaplan, SH, Greenfield, S, Gandek, B et al. Characteristics of physicians with participatory decision-making styles. Ann Intern Med 1996; 124: 497–504.CrossRefGoogle ScholarPubMed
Ong, LM, Haes, JC, Hoos, AM, Lammes, FB. Doctor–patient communication: a review of the literature. Soc Sci Med 1995; 40: 903–18.CrossRefGoogle ScholarPubMed
Coulter, A.Patients' views of the good doctor. BMJ 2002; 325: 668–9.CrossRefGoogle ScholarPubMed
Hickson, RB, Clayton, EW, Entman, SS et al. Obstetricians' prior malpractice experience and patients' satisfaction with care. JAMA 1994; 272: 1583–7.CrossRefGoogle ScholarPubMed
Ambady, N, Plante, D, Nguyen, T et al. Surgeons' tone of voice: a clue to malpractice history. Surgery 2002; 132: 5–9.CrossRefGoogle ScholarPubMed
Maguire, P, Pitceathly, C. Key communication skills and how to acquire them. BMJ 2002; 325: 697–700.CrossRefGoogle Scholar
Smith, S, Hanson, JL, Tewksbury, LR et al. Teaching patient communication skills to medical students: a review of randomized controlled trials. Eval Health Prof 2007; 30: 3–21.CrossRefGoogle ScholarPubMed
Paice, E, Heard, S, Moss, F. How important are role models in making good doctors?BMJ 2002; 325: 707–10.CrossRefGoogle ScholarPubMed
,National Health and Medical Research Council. Communicating with Patients. Advice for Medical Practitioners, NHMRC, Canberra, 2004. http://www.nhmrc.gov.au/publications/synopses/e58syn.htmGoogle Scholar
Buckman, R.Communications and emotions. BMJ 2002; 325: 672.CrossRefGoogle ScholarPubMed
Marteau, TM, Humphrey, C, Matoon, G et al. Factors influencing the communication skills of first year clinical medical students. Med Educ 1991; 25: 127–34.CrossRefGoogle ScholarPubMed
Langewitz, W, Denz, M, Keller, A et al. Spontaneous talking time at the start of consultation in outpatient clinic: cohort study. BMJ 2002; 325: 682–3.CrossRefGoogle ScholarPubMed
Beckman, AB, Frankel, RM. The effect of physician behaviour on the collection of data. Ann Intern Med 1984; 152: 692–6.CrossRefGoogle Scholar
Robertson, K.Active listening: more than just paying attention. Aust Family Physician 2005; 34: 1053–5.Google ScholarPubMed
Bruera, E, Palmer, JL, Pace, E et al. A randomized trial of physician postures when breaking bad news to cancer patients. Palliat Med 2007; 21: 501–5.CrossRefGoogle ScholarPubMed
Neuwirth, ZE.Physician empathy – should we care?Lancet 1994; 350: 606.CrossRefGoogle Scholar
Balint, M.The Doctor, His Patient and the Illness. 2nd edn. Pitman Medical, London, 1964.Google Scholar
Hislop, I.Stress, Distress and Illness. McGraw Hill, Sydney, 1991.Google Scholar
Barbour, AB.Caring for Patients: A Critique of the Medical Model. Stanford University Press, Stanford, 1995.Google Scholar
,Department of Human Services Victoria. Making the Connection. http://www.dhs.vic.gov.au/multicultural/connection/index.htm
,ACT Office of Multicultural Affairs. Working with Interpreters. http://www.dhcs.act.gov.au/matsia/multicultural/publications
,Multicultural Disability Advocacy Association. Using Interpreters Successfully. http://www.mdaa.org.au/faqs/interpreters.html
Dobson, R.Sharing of uncertainty can unnerve patients. BMJ 2002; 325: 1319.CrossRefGoogle Scholar
Niselle, P.Angered patients and the medical profession. Med J Aust 1999; 170: 576–7.Google Scholar
Vincent, C, Young, M, Phillips, A.Why do people sue doctors? A study of patients and relatives taking legal action. Lancet 1994; 343: 1609–13.CrossRefGoogle ScholarPubMed
Hickson, GB, Clayton, EW, Githens, PB et al. Factors that prompted families to file medical malpractice claims following perinatal injuries. JAMA 1992; 267: 1359–63.CrossRefGoogle ScholarPubMed
Kraman, SS, Hamm, G.Risk management: extreme honesty may be best policy. Annals Int Med 1999; 131: 963–7.CrossRefGoogle ScholarPubMed
Niselle, P.Caring for angry patients. Australian Doctor 16 July 1999, p. 56.Google Scholar
Daniel, AE, Burn, RJ, Horarik, S.Patients' complaints about medical practice. Med J Aust 1999; 170: 598–602.Google ScholarPubMed
Myerscough, PR. Talking With Patients: A Basic Clinical Skill. Oxford University Press, Oxford, 1989.Google Scholar
Hinton, J.Whom do dying patients tell?Br Med J 1980; 281: 1328–30.CrossRefGoogle ScholarPubMed
Charlton, RC.Breaking bad news. Med J Aust 1992; 157: 615–21.Google ScholarPubMed
Kubler-Ross, E.On Death and Dying. Macmillan, New York, 1969.Google Scholar
Hinton, J.Dying 2nd edn. Penguin, Harmondsworth, Mddx, 1972.Google Scholar
Ainsworth-Vaughan, N.Claiming Power in Doctor–Patient Talk. Oxford University Press, New York, 1998.Google Scholar
Anderson, I.Koori Health in Koori Hands: An Orientation Manual in Aboriginal Health for Health-care Providers. Koori Health Unit, Health Dept., Melbourne, Victoria, 1988.Google Scholar
Del Mar, CB.Communicating well in general practice. Med J Aust 1994; 160: 367–70.Google ScholarPubMed
Ferguson, B, Browne, E (eds). Health Care and Immigrants: A Guide for the Helping Professions. MacLennan & Petty, Sydney, 1991.
Gask, L, Usherwood, T. ABC of psychological medicine: the consultation. BMJ 2002; 324: 681–2.CrossRefGoogle ScholarPubMed
Hinton, J.Dying. 2nd edn. Penguin, Harmondsworth, Mddx, 1972.Google Scholar
Kerr, DN.Teaching communication skills in post-graduate medical education. J R Soc Med 1986; 79: 575–80.CrossRefGoogle Scholar
Kleinman, A, Eisenberg, L, Good, B.Culture, illness and care: lessons from anthropologic and cross-cultural research. Ann Intern Med 1978, 88; 251–8.CrossRefGoogle ScholarPubMed
Kubler-Ross, E.On Death and Dying. Macmillan, New York, 1969.Google Scholar
Myerscough, PR. Talking with Patients: A Basic Clinical Skill. Oxford University Press, Oxford, 1989.Google Scholar
,National Health and Medical Research Council. Cultural Competency in Health: A Guide for Policy, Partnerships and Participation. NHMRC, Canberra, 2006.Google Scholar
Pauwels, A.Cross Cultural Communication in the Health Sciences: Communicating with Migrant Patients. Macmillan Education Australia, South Melbourne, 1995.Google Scholar
Pendeleton, D, Schofield, T, Tate, P et al. The New Consultation: Developing Doctor–Patient Communication. Oxford University Press, Oxford, 2003.CrossRefGoogle Scholar
Reid, J, Trompf, P (eds). The Health of Aboriginal Australia. Harcourt Brace Jovanovich, Sydney, 1991.
Silverman, J, Kurtz, S, Draper, J. Skills for Communicating with Patients. Radcliffe Medical Press, Oxford, 1998.Google Scholar
Stewart, MA, Roter, D (eds). Communicating with Medical Patients. Sage Publications, Newbury Park, CA, 1989.
Whitehouse, CR. The teaching of communication skills in United Kingdom medical schools. Med Educ 1991; 25: 311–18.CrossRefGoogle ScholarPubMed

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