Impact and importance of effective communication in healthcare delivery
Patients' perceptions of the quality of the healthcare they receive are highly dependent on the quality of their interactions with the healthcare team. The connection that a patient feels with the clinician can ultimately improve their health mediated through participation in their care, adherence to treatment and understanding of the disease.
Extensive research has shown that no matter how knowledgeable a clinician might be, if s/he is not able to open good communication with the patient, s/he may be of no help. A healthcare team member's communication skills establish strong positive relationships with the patient's capacity to follow through with medical recommendations, coexist with their chronic medical condition and adopt preventive health behaviour. In my close to two decades of work experience in healthcare industry I have seen clinician's ability to explain, listen and empathise can have a profound effect on biological and functional health outcomes as well as patient satisfaction and experience of care.
Interviewing the patient with history taking is the most commonly used tool that the clinician employs in his consultation. Most diagnostic decisions come from this, yet studies of clinician-patient visits reveal that patients are often not provided the opportunity or time to tell their story/history often due to interruptions or less time, which compromise diagnostic accuracy. Incomplete history often leads to incomplete data upon which clinical decisions are made. When interruptions occur, the patient may perceive that what they are saying is not important and leads to patients being reticent to offer additional information; which is a deterrent to collecting essential information and it hinders the doctor-patient relationship leading to patient's non-adherence to therapy.
Patients disagree with what the clinician wanted to do; some are concerned about the cost, some find the instructions too difficult to follow, some do not understand what they are supposed to do. We further find adults with chronic illnesses underuse their prescription medication due to cost concerns; yet they fail to communicate this information to their physician. We also find some hospitalised patients not being able to identify their diagnoses or the names of their medication(s) at discharge which is an indication of ineffective communication with their physicians.
A common concern prevailing in our healthcare scenario is lack of adequate training of healthcare professionals in the delivery of high quality patient-centred care underscoring core communication skills such as open-ended inquiry, reflective listening and empathy as a way to respond to the unique needs, values and preference of individual patients. Clinicians and other members of the healthcare team conduct thousands of patient interactions during their career, yet communication training for clinicians and other healthcare professionals historically has received far less attention throughout their training process than have other clinical tasks.
Similar to other healthcare procedures, communication skills can be learned and improved upon. Improvement in communication skills requires commitment and practice. Given the wealth of evidence linking ineffective clinician-patient communication with increased malpractice risk, non-adherence, patient and clinician dissatisfaction, and poor patient health outcomes, the necessity of addressing communication skill deficits of healthcare practitioners is of utmost importance.
The writer is the Chief of Communication and Business Development at United Hospital Ltd. Email: dr.shagufa.anwar@gmail.com