Appendix 24a - Communication

by Michael Greger, MD and United Progressive Alumni

[ Medical School Resources | Appendices | Discussion ]

From the journal Medical Education: "It is [now] well documented that medical training is associated with a reduction in communication skills."[292]

One has a greater sense of intellectual degradation after an interview with a doctor than from any human experience - Alice James

From the news wire: "A poor bedside manner may be hazardous to a doctor's wallet, a new study says...."[293] Studies as far back as 1970 show that, despite the wallet motive, the interpersonal skills of medical students not only don't improve during school, they may actually get worse.[294]

Patients and doctors have a different ideas of what good communication even is. One study compared how supervising physicians graded medical students' ability to communicate versus how patients themselves graded the students. Quoting from the study, "The findings suggest that the communication skills emphasized by academic teachers do not reflect the skills important to patients. That there was so little agreement between these two perspectives should be a matter of concern."[295]

I hate the giving of the hand unless the whole man accompanies it - Emerson

"Good bedside manner, in fact, is good theater... I clear my voice and straighten my white coat. Curtain time is never far away" - Dr. Hoffman, Internist, Boston's Brigham and Women's hospital.[296]

In an article for surgeons on how to better communicate with patients, the surgeons are assured that they, "do not need to share their patients' feelings in order to communicate effectively.... An empathetic response is not about what you feel; it is an interviewing skill.... In fact it doesn't matter what you feel; you do not have to feel."[297]

A typical empathetic encounter in Appendix 24b.


[292] Medical Education 28(1994):190.

[293] UPI Science News 3 October 1998.

[294] British Medical Journal 310(1995):527.

[295] Cooper, C and M Mira. "Who Should Assess Medical Student's Communication Skills." Medical Education 32(1998):419-421.

[296] Hoffmann, SA. "The Doctor as Dramatist." Newsweek 1 February 1988:15.

[297] Sandrick, K. Bulletin of the American College of Surgeons 83(1998):13-17.

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