Good morning Doctor”, “I have a headache”, “Can you give something to help me sleep”, “Take these and come back to see me in a few days” …. exchanges like these are common in the day-to-day between health professionals and patients. The words are often spoken in a distant and stressful setting, in which the computer far too often takes centre stage.
In a modern world where technology has come to play a significant role, the patient may sometimes be relegated to the back seat.
It seems a contradiction to say that in the age of communication, everybody seems to communicate less and even communicate worse, but unfortunately this is a reality and in by no means is this exclusive to the relationship between professional and patient.
When we refer to communicating “less” here, we do not mean in terms of quantity but mostly in terms of the quality of communication. There are very few practices in the world of health that do not involve communication, as such a good bedside manner is an essential part of patient-professional communication, between health professionals or with the general public.
For over 30 years, the Toronto Consensus Report has been highlighting the need for greater efforts to improve clinical communication. They often refer to the importance of emotion-based medicine, which states that the doctor-patient relationship should be based on the assumption that patients are sufficiently mature and aware of their health status. We come from an authoritarian society and a medical practice based on paternalistic models.
The democratic values of our society may never have been all that sound and we’re still learning. Society itself has often bestowed on doctors a privileged social position that tends not to facilitate a suitable flow of communication with patients.
Obviously, there are other factors which do not help or make life easy for professionals, such as their heavy workload or the design of physicians’ facilities which clearly have not been fashioned with the patient in mind.
The training of health professionals is probably a key tool in ensuring that our physicians, and nurses are people with a close connection to their patients, interested in and capable of listening, interpreting, understanding non-verbal communication, are compassionate and assertive. In addition to addressing technical and technological aspects of the sector, medical and nursing faculties must also make room for the ethical and humanistic aspect of the studies.
There are plenty of initiatives becoming available to assist healthcare students in developing communication skills with the capacity to ensure that the relationship between professionals and patients is much more effective and affective.
However, once we have established the importance of these skills in the future professional’s curriculum, their acquisition becomes compulsory and their assessment critical. Recently, a set of recommended modifications to student curricula were published, regarding both content and teaching strategies to be used in different countries and settings (Kiessling, Bachmann, García de Leonardo).
It seems that consensus is not far off and therefore, all that remains is to implement these proposals in our universities and medical centres. When this takes place, it will most likely mean a win-win situation for all those involved.
Surely if we can manage to train our professional staff to be compassionate, assertive, practice active listening and empower patients in decision making, then we will achieve better health outcomes and greater wellbeing for both patients and their families, not to mention for the health professionals themselves.
Post written by Carme Carrion (@CarmeCarrion), Professor of Healthcare Studies at the Universitat Oberta de Catalunya (UOC) and Associate Professor at the Universitat de Girona (UdG).
