Beyond Bedside Manner: Effective Provider-Patient Communications

Effective communication between provider and patient is a critical component of all patient-centered care. As a health communications professional, I appreciate this fact. As a mother/patient/caregiver, I appreciate it even more. 

We’ve all had that moment in the doctor’s office either as patient or caregiver… “The test results are positive,”…is that a good thing? “The numbers are borderline,”…so we’re in the clear until next year’s exam? “We will explore palliative care,”…is that the same as hospice?

The American Society of Clinical Oncology (ASCO) recently issued new guidelines to improve clinician communications with patients. Particularly in the context of a diagnosis like cancer, clinicians must have the ability to support patients by effectively building rapport, providing information in a manner that the patient understands, and addressing patient concerns in a complete yet concise way. The guidelines include recommendations for core communication skills and training, and strategies for communicating effectively, particularly when barriers exist.

As the Journal of Clinical Oncology notes in an article about the guidelines, “Good interpersonal skills are not a substitute for strong health care communication skills.” ASCO is one of many professional organizations that have come to recognize that communication is not a ‘soft skill’ for clinicians, but is in fact a critical element of their profession. In recent years, more and more provider organizations, public health entities, and federal agencies have developed guidance, tools, and resources to enhance provider-patient communications and to make the most of the often limited time a clinician has to spend with a patient.

The CDC and the NCI define health communications as “The study and use of communication strategies to inform and influence individual decisions that enhance health.” From cancer to vaccination to diabetes, our Hager Sharp team has worked with clinicians to strengthen their confidence and ability to communicate effectively with patients and their caregivers.  We’ve identified four core elements of effective provider-patient communications that are consistent across clinical practice, specialty area, or diagnosis.

• Use clear, plain language. Whether taking a medical history, sharing test results, or explaining a diagnosis or treatment plan, clinicians should avoid medial jargon, abstract concepts, and long, complex sentences. Additionally, remember that stress, illness, and uncertainty can affect comprehension and a person’s ability to process information.
• Educate as well as inform. A provider’s role goes beyond simply reporting test results or a diagnosis. Help the patient understand what you mean. In some cases, this means clinicians can use visual aids to ‘show’ in addition to ‘telling’.
• Listen not just to ‘hear’, but to understand. Listen to what the patient or caregiver is saying, carefully and with empathy. Then, formulate your response. This can be a challenging exercise when a patient has a lot to say, but there are communications tips and time-savers to help guide your discussion. Establishing a dialogue goes a long way toward building rapport, trust, and understanding.
• Ask the patient to share their understanding. Can the patient briefly and accurately share their understanding of your diagnosis, recommendation, or medical orders? Ask them to repeat key points back to you to make sure they have a clear understanding before they leave the office.

Increasing the quality of communications skills among providers is worth the time and investment that professional organizations like ASCO are dedicating, and when implemented will no doubt improve health outcomes. And that benefits everyone.

Katherine Nicol, M.S.
Senior Vice President