Engaging patients through effective communication

Handshake-With-DoctorGood communication between health professionals and patients is essential for high-quality health care.

According to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient experience survey, communication with physicians ranked fifth out of eight categories in terms of correlation with overall patient satisfaction.1

However, today, finding an effective communication to align the physician-patient relationship has become a serious challenge.

Due to a lack of familiarity with medical terminologies and poor health literacy, patients find it difficult to understand and follow basic health information given to them by a healthcare provider.

Time constraints deprive the physician and staff of having meaningful conversations with their patients. As reported by the Times of India, the “World Medicines Situation 2011” report published by the WHO said that doctors in developing countries, on average, spend less than 60 seconds in prescribing medicines and explaining the regimen to their patients.2

Patient complaints about health professionals frequently focus, not on a lack of clinical competence per se, but rather on a perceived failure of communication and an inability to adequately convey a sense of care.3

A large number of patients leave the consultation without asking questions about things that are troubling them or do not receive what they regard as a satisfactory response.4
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A recent qualitative study based on 35 patients, aged 18 years and over, consulting 20 general practitioners, found that only four of the 35 patients voiced all of their concerns during the consultation. The most commonly voiced concerns were related to symptoms, requests for diagnoses and prescriptions. The most commonly unvoiced concerns were personal worries about possible diagnoses and what the future holds, ideas about what is wrong, side effects, not wanting a prescription, and information relating to social context, such as housing, work or social networks. Failing to raise such concerns often led to specific problem outcomes, such as major misunderstandings, unwanted prescriptions, non-use of prescriptions and non-adherence to treatment.4

A significant portion of adverse events are caused by breakdowns in communication among caregivers, and between caregivers and patients.2 Patients who have trouble understanding their physician have a longer average length-of-stay and a higher mortality rate.5 Non-compliant patients in the physician-patient relationship more often cancel surgical procedures at the last moment.

Communication issues have also been an important factor leading to medical litigation. Poor communication between healthcare providers and patients causes a breakdown in care, and many patients even switch their physicians. Basically, there emerges a lack of mutual understanding between the two, which leads to an erosion of trust.

By omitting patient-focused communication initiatives, healthcare organizations face adverse clinical, financial and even legal outcomes.6

Therefore, effective communication is the mainstay of medical consultation.

To sufficiently understand the patient, the dialogue between the patient and the physician needs to be tailored to the patient’s concerns, feelings and expectations. This requires the physician to be adaptable to different styles of communication.

This requirement to adapt to different communication styles means being able to perceive the verbal and non-verbal cues through the tone of voice, facial expressions or actions of the patient. It could be an important mode of gathering more detailed information about the patient. Asking open-ended questions gives the patient more time to think and elaborate on their concerns, rather than simply closing the consultation by giving advice.

Good communication can:7

  • help patients understand complex information
  • aid in making appropriate choices between treatment options
  • create more awareness of the side effects and potential hazards of some procedures
  • bring clarity to likely therapeutic gains and the purpose of treatments
  • help patients keep to drug regimens and diets
Dr. Shalini Ratan Dr. Shalini Ratan, MD, is Founder and Chief Knowledge Facilitator at Nirvan Life Sciences Pvt Ltd. Mumbai, India.

References (click to show/hide)

  1. Matthew P.et al. The Patient Experience and Health Outcomes. N Engl J Med.2013; 368(3):201-203.
  2. Dr. Shalini Ratan. Good Medical Practice: A New Focus on Communication. Indian Journal of Healthcare Quality and Management: July-Sept, 2012; 61-62.
  3. Moore PM et al. Communication skills training for healthcare professionals working with people who have cancer (Review). The Cochrane Library 2013, Issue 3.
  4. Myfanwy Morgan. The Doctor–Patient Relationship. Available at http://faculty.ksu.edu.sa/nadalyousefi/communication%20skills/The%20Doctor%E2%80%93Patient.pdf. Accessed on 24th October 2013.
  5. Baker, D “Health literacy and mortality among elderly persons.” Archives of Internal Medicine 2007; 167(14): 1503 – 9.
  6. Patient Engagement as a Quality Improvement Strategy. Available on http://www.emmisolutions.com/
  7. Lesley Fallowfield. Communication with patients after errors. Journal of Health Services Research & Policy 2010; 15 (Suppl 1): 56–59.


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This entry was posted in Practice Management and tagged , . Volume: .


    Posted Nov 2013 at 2:41 pm | Permalink

    Patient safety and education are vital for doctor patient long standing
    relationship. Thorough explanation of side effects, , sparing more time for communication may strengthen the relationship. First win the confidence of patient then every thing follow. Comfort is more important than cure.

  2. drvchacko mammen
    Posted Nov 2013 at 1:57 pm | Permalink

    good secret behind good practice

    Posted Dec 2013 at 12:28 pm | Permalink

    most of busy doctors are lacking in communication skill due to time.
    this article will help to understand important of communication skill.

  4. Dr. Shalini Ratan
    Posted Dec 2013 at 5:40 am | Permalink

    Thanks to All for their valuable time to read the article.

    Articles are Food for Thought. We need to go a long way to bring transformation in Medical Practice.

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