When pediatrician Elizabeth Rider walked into her exam room to see a toddler a few years ago, she was puzzled. The child's mother was concerned about a rash the child had developed, but two practitioners had already examined the patient at two previous appointments, and both had reassured the mother there was nothing to be concerned about.
"There was some frustration among staff," acknowledges Rider. "I thought, 'Well, there's a reason she's back.'"
Shortly after the appointment began, Rider, who is now an assistant professor of pediatrics at Harvard Medical School, asked the child's mother if she was concerned about anything else. The woman replied, "My husband died."
At that moment, both Rider and the mom realized the mother's concern wasn't the rash, it was the bigger picture. "When you have a loss, when somebody dies, patients worry about other losses — and nobody heard her," says Rider, who spent the rest of the appointment talking with woman about her situation and providing coping resources. As a result, the woman's anxiety about the rash dissipated, and the real issue underlying her anxiety was addressed.
"By building rapport, understanding the patient's perspective, and seeing the patient as a person in every encounter, we won't miss the big things," she says. "It doesn't take much time to say, 'Any other concerns? What else is going on?'"
Simple communication missteps like the one Rider solved have big consequences for doctors and patients. They often lead to wasted time, poor outcomes, decreased patient satisfaction, and malpractice lawsuits. Here's how to brush up on your communication skills to ensure your patients are getting exactly what they need from you.
At the core
You're dealing with complicated diagnoses, critical decisions, shorter patient visits, and declining reimbursements. It's easy to let communication slide to the back burner. Don't let it. "Communication isn't something that you have to do on top of being a physician," says Jason Wolf, executive director of The Beryl Institute, an organization dedicated to improving the patient experience. "It's really a core clinical skill and a muscle that you have to develop through constant practice."
That's because communication rests at the "core" of patient care, says Wolf. Communicating well ensures your patients understand their current situation and your directions for ongoing care, he says. It also ensures you understand your patients' perspectives so that you can tailor their treatment plans to best suit their needs and values, says Houston, Texas-based regional hospice medical director and palliative-care physician Marcia Levetown, who teaches communication skills to physicians.
Evoke what you know
We could provide you with a list of communication skills — such as making eye contact, sitting near the patient, and listening closely — but you've seen them all before. The trick is developing those skills and making them your own. "The 'aha' is this isn't rocket science," says Wolf. "Effective communication is just about intentionality and bringing our humanness in the delivery of healthcare."
Remember that as long as you put the patient first, there is no one right tactic to use when communicating, says Levetown. "You can't put on a costume or a mask," she says. "You should develop your own style that you're comfortable with."
The good news is that finding your own style isn't a "big arduous process," says Wolf. It's simply cultivating what feels natural to you. "Is it adjusting the tone of voice, the posture, the gestures? Is it having a question that you want to ask that sort of sets the tone for you? Is it being a little bit self-revealing or self-effacing to kind of remove the mystique of being a physician, which to so many people is intimidating and sometimes scary?" he asks. "You have to practice style and communication etiquette that matches who you are."