The Lost Art of Communication Between Doctor and Patient

The relationship between a physician and a patient plays a vital role, as the patient is in one of the most crucial, vulnerable moments of his or her life. This requires doctors to be at their best at all times—during both duty hours and non-duty hours—with every patient, to gather information, make an accurate diagnosis, counsel appropriately, give therapeutic instructions, and establish caring relationships.

The doctor-patient communication is a skill that has been losing its efficiency over the years. Once a medical student goes through years of preclinical and clinical postings, and ends up as a medical intern, they begin with another level of postgraduate and super-specialty training. With every patient they see from day one of their journey, a majority of physicians follow a downward curve and fail to maintain their efficacy due to various unspoken factors.

Doctors may struggle to maintain the quality of communication due to factors, such as the emotional and physical brutality of medical training, academic/peer pressure, and long, inhumane working hours—particularly during internship and residency—which suppress empathy, substitute survival coping techniques, and cause them to lose themselves in the process of becoming better physicians.

In extreme cases, this emotional fatigue may manifest as detachment or even dismissiveness toward patients.

According to a review published in the Patient Education and Counseling Journal, studies on doctor-patient communication have demonstrated patient discontent even when many doctors considered the communication adequate or even excellent. Doctors tend to overestimate their abilities in communication.

It also takes a good amount of time to discuss a patient's complaint, disease progression and treatment plan, as well as to clarify their doubts, which is a major issue given the doctor-patient ratio in the country’s government hospitals. There is always a demand for more doctors in the hospitals to allow the required time per patient; otherwise, the burden on a single doctor becomes enormous. This issue is not as prominent in a private hospital setup.

Patients can form their sense of image through personal and social views, which can lead to differences in expectations. However, effective communication from both parties is crucial. It involves the doctor’s ability to ask the right set of questions based on their knowledge and experience. In turn, the patient must answer honestly to enable effective and stable communication, which leads to accurate diagnosis and treatment.

Most complaints about doctors are related to issues of communication, not clinical competency. Patients want doctors who can skillfully diagnose and treat their illnesses as well as communicate with them effectively. This may lead to higher-quality outcomes, better satisfaction, greater patient understanding of health issues, and better adherence to the treatment process.

Restoring empathetic communication in medical practice is not just a soft skill—it is a clinical necessity. As medicine advances, so must the art of human connection that lies at its heart.

Reference:

1. Ha, Jennifer F., and Nancy Longnecker. "Doctor-Patient Communication: A Review." Ochsner Journal 10, no. 1 (2010): 38–43. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096184/.

By Dr. Sai Vinthiyaa Gopinath, MBBS

_MSM/DP