Communication is key in health care. But what exactly is it?


Contributors on this site regularly recommend improved doctor-patient communication. Indeed, that’s one reason I’m a devoted reader. But we need to articulate exactly what “communication” is.

When I ask colleagues about that word, they usually define it as what they say to patients. I can’t argue with that. Yes, we need to express ourselves clearly and simply. But communication includes much more.

The occasional complaints I hear from patients about their care are never about medicine’s high-tech presence. Instead, they’re uniformly about deficiencies in communication, actually healthcare’s lowest-tech aspect. Too often, patients say, they’re treated almost like bystanders.

A convalescing friend told me, “When I was in the hospital, I was poked and probed and ultraviolated, but never touched.”

Others have said:

“When I phone my doctor’s office, I have to navigate a difficult phone tree, and even then I hardly ever get to speak with a person.”

“My doctor doesn’t face me. He just types into his laptop.”

“I waited all day by the phone for the call the clinic promised. Never came.”

“When I was hospitalized, the only staff member who just sat down and talked with me was the janitor.”

“No one asked me whether I could afford this prescription, eighty bucks a pill.”

“It seems like my doctor always keeps one hand on the doorknob.”

“I hear about the importance of diet, exercise, and coping with stress, but no doctor’s ever asked me a thing about how I live my life.”

“How is it medical science can transplant half our organs, but can’t fax my test results across town?”

These examples may seem minor annoyances, but patients can conclude from their prevalence that medical people often practice hardly knowing, let alone comforting them.

Sure, the financial demands of current practice necessitate speed and shortcuts. We need to recognize, though, that this atmosphere erodes professional standards. More to the point, it generates suboptimal medicine. I’ve heard cynics joke about future health care as a system of vending machines. If we continue accepting the pruning of humanity — that is, communication — from medical practice, that’s exactly where we’re heading.

Jeff Kane is a physician and is the author of Healing Healthcare: How Doctors and Patients Can Heal Our Sick System.

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