In a dimension as sensitive as Health, and more specifically, in the communication between doctor and patient, the process of communication between these interlocutors takes on an extremely particular and unique connotation. Several studies have shown that this activity is not always carried out in the best possible way.
What can be done to improve this unique communication process?
The complexity that a simple process can reach, such as delivering a message, involves the appropriate choice of words as well as active listening to the patient’s needs.
We can illustrate the communication process as follows:
As we can see in the figure, in the process where the sender transmits a message to a receiver, despite seeming simple, there are some elements that make this activity more complex, such as the encoding/decoding of the message and the noise that can be involved in this interaction.
Encoding would be the appropriate choice of words by the sender (doctor) and the tone of the message itself, so that it can be clearly understood (decoded) by the patient (receiver).
Regarding the content of the message itself, we must agree that there is nothing so complicated in medicine that, if explained in clear and simple language, cannot be understood by any layperson.
It is also important to remember that, as in any communication process, when there are gaps or empty spaces, people tend to unconsciously fill them with the worst possible alternatives. It’s as if our sense of survival wants to prepare us for the worst possible catastrophes, for the apocalypse.
Thus, in the communication between doctor and patient, if the information is not clear and complete, the patient may feel a lack of transparency. What remains is distrust, reducing the chances of a correct diagnosis, the success of the therapeutic approach, and other potential consequences.
This topic was addressed by Professor David A. Shore, from the Harvard School of Public Health (founder of The Harvard School of Public Health’s Trust Initiative), wisely titled his book “The Trust Crisis in Healthcare” (Editora Oxford) and addresses this issue in chapter 18 of the publication.
We can conclude that the specific skills and competencies of a medical professional are inseparable from their respective communication skills. It’s not an exchange. One does not compensate for the other. But these communication skills can and should be developed to bridge this gap and increase satisfaction, treatment success, and reduce the perception of medical error due to a lack or neglect of appropriate dialogue.
Here and today, the crux of the matter is the concept that doctors take care of diseases. Wrong. Doctors take care of people.
Medical care is a human interaction between doctor and patient, in a specific context that is the social system itself. And this interaction should ideally be firmly grounded in the highest level of trust possible.
Contradictory or even paradoxically, this trust is vigorously reinforced when a doctor explains what they know and don’t know, what they have already discovered and what they haven’t, the potential points that may still be unclear, which assumptions they can explain, and which others may require more time, analysis, observation, or even research.
The way a doctor expresses their recommendations strongly influences the reactions, attitudes, and choices of a particular patient, including increased treatment adherence and decreased potential risk of understanding or interpreting a communication failure as a “medical error.”
And when we talk about the “way of expressing oneself,” we are referring to communication styles. These styles (based mainly on certain psychological characteristics) also change and adapt to the conditions of the context.
Having the correct awareness of one’s own communication style will certainly help facilitate this dialogue between doctor and patient.
And it is precisely there that I believe there is a considerable and important margin for improvement in the communication process between doctor and patient, with possible and concrete gains for all parties involved.
It all depends on the willingness, self-awareness, and clear focus on purpose.
