Communication


Communication is perhaps the most important part of being a doctor. It doesn't matter if you are smarter than your peers if you can't communicate important information effectively to your patients. Your patients will judge you based on how you interact with them. Unfortunately, in most institutions there is no proper training given to students in this area.

Effective communication is more art than science. It is difficult to describe but you know it when you see it. Some are more natural at it than others but regardless of your personality, it takes a lot of effort to become good at it. Dealing with emergencies, death etc is never easy.

Patients will refuse care/certain treatments all the time. Some are not too serious while others can be life threateningly stupid. Most of the time, people will make bad decisions because they haven't been properly informed of the consequences. It is essential to avoid confusion in this regard.

What I know about communication mostly comes from watching my professors communicate and a little from my ACLS course a few years ago. Here some points I feel are important

  - Always avoid as much medical jargon as possible. People won't understand it and are unlikely to ask doubts if they don't.
  - Try to explain things in the simplest possible way while at the same time emphasizing the most important points.
  - Don't beat around the bush. If the patient's condition is life threatening or terminal, say so. Avoid all possible confusion here.
  - Try to avoid giving bad news in very public areas. Allow some privacy (if possible) for family members to process the information.
  - Avoid confrontations with patients/bystanders as much as possible. Learn to defuse these situations, not add fuel to fire. I know we all love to let our temper get the better of us, but it rarely makes us look good. You'll earn more respect in the long run by acting in a dignified manner in difficult situations.
  - If there is a difficult medical decision to be made, make sure the patient and bystander know exactly what the benefits and risks are. If you don't do this and just document that the patient gave consent/refused care, you can still get into big trouble.
  - Document good communication. Makes you look better from a medicolegal standpoint. You may be saying all the right things to the patient and family but it won't count in court unless you document it.
  - Try to maintain a pleasant demeanor whenever appropriate (easier said than done admittedly). This will help create good doctor-patient relationships.
  - Always show interest in the patient's concerns and their health. No patient wants to hear a doctor disregard their fears. 

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