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Article Excerpt
Many training curricula, research efforts, and resources have been focused on what makes competent doctor communication. However, few studies have identified what makes good patient communication. This project was designed to explore physicians' perspective on patient communication. Forty-one primary care physicians participated in focus group discussions on what constitutes competent patient communication. The results of these discussions pointed to three areas of competent patient communication: (1) patients' knowledge of their own health, diagnosis and medications, (2) communication skills in organizing and prioritizing, and presenting clear, concise descriptions of symptoms, and (3) personal attitudes of ownership, trust, and honesty. Focusing on teaching patients these specific skill areas will facilitate a more effective medical visit.
Keywords: doctor-patient communication, patient communication, patient medical knowledge, doctors' attitudes toward patients, patient-centered healthcare
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Even though there are many advances in medical technology, patient-physician communication remains at the core of compassionate and competent medical care. Doctor-patient communication continues to be an essential educational focus in training future physicians. The Institutes of Medicine (IOM) and the Accreditation of Council of Graduate Medical Education (ACGME) have made this aspect of medical care a top priority (ACGME, 2005; IOM, 2003). In medical schools and residency programs, there are numerous curriculum resources for training doctors in communication skills. Doctors have been the focus of the vast majority of research and training in doctor-patient communication. Overall, research studies have shown that communication is linked to quality health care. Some studies have found that better ratings of the patient-physician communication were related to the patient's ability to remember the doctor's recommendations and comply with the instructions (Bartlett et al., 1984; Kaplan, Greenfield, Gandek, Rogers, & Ware, 1996; Ong, DeHaes, Hoos, & Lammes, 1995). There have also been studies that show more favorable biomedical outcomes for patients when there is mutual communication between the physician and patient (Greenfield, Kaplan, & Ware, 1985; Orth, Stiles, Scherwitz, Hennikus, & Valbona, 1987; Rost, Flavin, Cole, & McGill, 1991). There is a strong relationship between a patient's satisfaction with health care and the quality of the physician-patient communication (Kaplan, Greenfield, & Ware, 1989; Thompson, Nanni, & Schwankovsky, 1990).
However, while most medical training programs have addressed physicians' communication skills, few programs or projects have addressed the communication skills of the patients (Cegala, McClure, Marinelli, & Post, 2000; Ong et al., 1995; Post, Cegala, & Miser, 2002; Roter & Hall, 1989). Even recent studies identify "ideal physician behaviors" (Bendapudi, Berry, Frey, Turner Parish, & Rayburn, 2006), but the field ignores ideal patient communication. It is surprising that the patient component of the doctor-patient communication has received so little attention.
In a review of the literature, Post and his associates identified only 16 studies that focused on training patients in communication skills (Post et al., 2002). These studies ranged from 30 minutes of a one-to-one training session with a patient to patient pamphlets. Overall, the studies showed that patient training had a positive effect on the doctor-patient communication. Only a handful of studies have analyzed the interaction between doctors and patients. One study, for example, focused on the patient's ability to ask questions (Sleath, Roter, Chewning, & Swarstad, 1999). They found that while physicians asked an average of 9.3 questions regarding medications, 47% of patients asked none at all. In one study that investigated patients' asking medication questions, 467 outpatient visits were analyzed. Physicians asked on average 9.3 questions about medications while 47% of patients, almost half, did not ask any medication questions. Physicians rated patients who did ask questions as more interested and assertive than nonquestioning patients. In a series of studies on patient communication, Cegala and his associates evaluated communication skills training on patient's participation in health care (Cegala et al., 2000). They conducted a series of studies in which they compared three groups of patients: (1) patients who were trained in communicating with using a workbook, (2) patients who received information on talking with their doctor, and (3) patients who received standard care patients. They found that the trained patients were rated as more effective and efficient during the office visit. These trained patients provided more detailed...
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