Surviving AmericanSurviving
American Medicine

Communication between physicians and patients is crucial to delivering high quality medical care.  However, it is the experience of most patients that communicating with their physicians has become more difficult.

With healthcare reform, physicians often have less time to discuss things with their patients.  An informational brochure may be handed out, or physicians may simply say, “talk to my nurses for more information.”

In a recent set of articles in the Journal of the American Medical Association, the concepts of changing physician communication were discussed.  In an editorial summarizing this, A. Zuger made some important points (JAMA 2013, Volume 309; Page 2384).  The editorial created a new description “white-coat silence” meaning doctors neglected to tell patients information, or did not want to discuss some issues. Many times, physicians merely want to get on with the next patient, rather than spending time to give more information. Even when doctors give patients information, often patients are confused about what the physician is saying

In the editorial, it was recommended that new physicians be able to not only communicate care and compassion, but must be able to be comprehensible to patients.  The doctor should be able to be accurate in explaining the statistics of risk of disease and risk of treatments, and be understandable beyond the actual numbers.  It was also recommended that physicians understand how to explain clinical trials and research to patients so that they might be able to access new treatment programs in appropriate circumstances.  Lastly, physicians will have to be skilled in the ability to enter data into electronic records, while still relating to patients in an effective way.

Obviously, this applies not only to new physicians, but to all doctors, nurse practitioners and physician assistants.

Here are my tips for you:

• It is important to try to choose a doctor and/or nurse practitioner who is excellent in communication.
• It is important to select a doctor who utilizes electronic medical records to be able to help to explain things to you and to give you a copy of your record that you can read.
• It is important to be able to understand completely everything your physician says, so do not hesitate to stop them if the physician “loses you” when giving you information.
• Make certain that you ask the doctor about clinical trials available for your condition.
  

  Have a good conversation with your doctor

For my information on communication, see my book, “Surviving American Medicine.”