Communication

• Dr. Mousa Al-Omari: 'If you cannot work with love but only with distaste, it is better then you should leave your work and sit at the gate of the temple and take alms from those who work with Joy.'
• Consultation


  The central act of medicine
• Consultation


  1. Interview

  2. Exposition
• Doctor-centered consultation


  Doctor has authority, patient passive and relying on dr. Judgment
• Patient-centered consultation


  Patient is active, dr. encourage pt. to report not only symptoms but also their thoughts, feeling about their illness and their expectation of the consultation. Consultation should be more of a dialogue meeting between two experts.
• Diagnosis is made by

  • History (82%)
  • Examination (9%)
  • Investigations (9%)
• Compassion, interest and thoroughness are essential components of successful patient care
• Qualities of concerns, kindness, friendliness and cheerfulness all result in atmosphere of trust and confidence between patient and doctor
• It is not what you say but the way that you say it
• Communication is the foundation of all that we do
• Skilful communication has become widely recognized as a primary component of medical education
• We must heed the desperate voice of the patient trapped in technology crying "Speak" to me
• Up to half of all new hospital outpatients are suffering from psychological problems which may trigger physical symptoms without disease present
• Up to 25% of the eight common complaints (fatigue, back pain, headache, dizziness, chest pain, dyspnoea, abdominal pain, anxiety) have demonstrable organic disease
• Communication is a multi-level information exchange. It is not simply confined to words
• Communication is two-way processes both are active. Ensures an interaction rather than a direct transmission process
• Good communication is a patient's right
• Medicine is not "find it & fix it"
• Health care


  • Physical care
  • Cognitive care
  • Behavioral care
  • Psychological care
• The doctor either fails to understand the patients meaning or fails to convey his or her own meaning
• Symptoms


  A form of communication, the way in which a patient conveys feeling of illness, distress or discomfort (subjectives)
• There are problems related to symptoms e.g. anxieties, fantasies fears, work problems, family problems
• 54% of patient's complaints were not elicited
• 45% of patient's concerns were not elicited
• 50% of psychological problems were not elicited
• In 50% of the visits patients and doctors disagree on the main presenting problem
• In 50% of cases patients history were blocked by interruption within 24 seconds
• The importance of good communication should be highlighted if errors and misunderstanding are to be avoided
• Professional skills are still the most common cause of complaint from patient or their relatives and apparent weak point in doctor's professional competence
• Communication skill


  An absolute requirement in obtaining a history which provide a correct DX in more than half of all patients and in as many as 80% in primary care
• Communication skill


  Constitutes one of the cornerstones of therapy. The consultation ends with exposition
• Communication skill


  Educational advice and counseling can be expected to have an impact only if there is good communication
• Good communication


  Makes it less likely that dissatisfaction will end in litigation
• Most complaint about doctors (90%) are because of failure of communication rather than poor medicine
• More and more patients want to be involved in decisions about their own bodies and to participate in their own care and Rx
• Good communication improves health care
• The aims of communication are

  • To be heard
  • To be accepted
  • To be understood
  • To get action
• Elements to communicate


  • Speaking
  • Writing
  • Listening
  • Body language
• We are far more influenced by what we see than by what we hear
• 93% of all communication is non-verbal (38% tone of voice & 55% body language) & 7% words