Chapter 48 Communication skills
A doctor must integrate four components to achieve a successful consultation: (1) clinical knowledge; (2) problem-solving; (3) physical examination; and (4) communication skills. There is no point in having excellent factual knowledge if you cannot identify the reason why your patient attended, or help that patient understand a treatment plan.
If doctors are poor at doctor–patient communication there is increased risk of:
The centrality of communication skills in clinical practice is recognized by the General Medical Council in policy documents, including Good Medical Practice (2006). Doctors whose performance is seriously deficient in communication skills can have their registration removed or restricted in the UK. One factor emphasized in Medical Students: Professional Behaviour and Fitness to Practise (http://www.gmc-uk.org/students/index.asp) is the importance of not allowing your personal views about, for example, a patient’s religion or sexual orientation to influence the professional relationship or prejudice patient care.
The consultation
A consultation involves several key communication tasks which can be summarized as follows: (1) building a relationship with the patient (rapport); (2) gathering information (history-taking); (3) giving information (e.g. test results); and (4) carrying out these tasks in a coherent, logical way (Kurtz et al., 2004). The last factor is increasingly important with short appointment times (see pp. 90–91).
