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Medical Communication: A Detailed

Medical Communication: A Detailed Look Into Communication Between Doctors and Patients

Andrew A. Lechner, IV

Mississippi College


This paper will cover the broad spectrum of doctor-patient communication, looking at how doctors use certain protocols and ethical standards to communicate efficiently with patients. It will also explore the general history of doctors and hospitals to provide contextual information to the reader to better understand doctor-patient communication. Following this brief historical analysis, the paper will shift to talk about topics doctors would normally discuss with patients, such as end of life care, basic check up questions, etc. Statistics will also be widely used in this portion of the paper, as patients are constantly surveyed by hospitals in order to maintain quality assurance. After, there will then be training protocols explained that doctors have to learn and follow in order to fully do their jobs as doctors. Additionally, this paper will also explore what new trends doctors are following in order to maintain with the present day times on patient-doctor communication.

Keywords: communication, doctors, patients, analysis Introduction

There has been a vast number of studies done on the topic of medical communication, more specifically the communication that occurs between doctors and patients. Ethics plays a role in communication between doctors and patients. Medical communication has certain informal protocols that are followed by doctors in order to make the patients feel welcome. These protocols can be used in several different areas of medicine, including oncology, internal medicine, gerontology, etc. Communication between doctors and patients has also taken leaps and bounds in the last few years with the introduction of technology in hospitals worldwide. Through web applications and other online services, doctors are able to give patients access to their records and appointment reminders.

Ethics and Medical Communication

Hippocrates, ‘the father of modern medicine’, was instrumental in setting the general standard for ethics in the medical field. The Hippocratic Oath is still used in the medical field and sets the baseline for how doctors are supposed to treat patients. Hippocrates believed that ‘everything is divine and everything is human’ (Suvajdzic et. al 2016). By this statement, Hippocrates believed that everyone was to be treated as sacred, thus setting the background for the Hippocratic Oath. The Hippocratic Oath takes this belief and makes it apparent in the first paragraph when Hippocrates says, ‘I swear by Apollo the physician, aesculapius, all the Gods and Goddesses that according to my ability and judgement I will keep this oath and stipulation..’ (Kumar 2009).

In a study done by Ballo et al., two recommended decalogues for both the doctor and the patient are given. Understanding the first portion of the Oath, it is apparent that this decalogue employs a theme inspired by this. An example of a statement that shows this emphasis is the ‘I observe’ portion. In the statement, it says, ‘I make eye contact with the patient and observe his or her reaction while I tell him or her of the medical diagnosis and treatment option’ (Ballo et al. 2017). In this statement, it shows an empathetic approach to dealing with a patient and shows the individualistic and meaningful approach to what Hippocrates was saying. Ethics is important to medical communication because it allows the doctor to be able to do his job properly and it is also beneficial to the patient because it makes the conversation more humanistic and personal.

In the same study done by Ballo et al., the study was conducted with patients in the cardiology section of the Local Health Authority of Florence, Italy (Ballo et al. 2017). The study used notes dictated by the doctor to show issues that were being brought up and then responses were generalized to confront and produce a solution to what response would be appropriate. At the end of the appointment, patients were brought into a seperate room and then given three questionnaires to answer based on the clinical interaction between the patient and the doctor (Ballo et al. 2017). One questionnaire tested the methodological validity of the responses given (Ballo et al. 2017). In addition to taking the questionnaire, patients were asked to tell whether they had enough time to read the responses (Ballo et al. 2017). The reliability of the study was solidified through using two different processes to approximate internal consistency and test-retest reproducibility (Ballo et al. 2017). The split-half method was used to look at the correlation between odd and even numbered sets in the questionnaire given to the patients in the study. In addition, the Spearman-Brown prediction formula was applied to the questionnaire that was given to the patients in the study (Ballo et al. 2017).

Specific Subareas of Medicine and Medical Communication

Different areas of medicine call for different approaches of communication between doctors and patients. Oncology is the study of cancer, and is a tough field in the world of medicine to work in. Oncologists have to deal with telling patients serious diagnosis and now it is shown that patients are living longer with their diagnosis due to progress in medicine, thus this leads to doctors having to change their conversation to include messages of hope for patients that have an uncertain future (Libert et al. 2017). Older studies had shown that patients expected to talk to their doctors about ‘uncertainty and hope…to help them adjust to their diagnosis…and to maintain hopefulness.’ (Libert et al. 2017). There was a study conducted by Libert et al. where the purpose of it was to improve doctor communication with patients with the use of a communication skills training (CST) program (Libert et al. 2017). The study will be evaluated by looking at changes over time in how physicians’ communication skills and the physicians’ physical and mental health. The participants of the study were physicians that are specialists or they have cancer patients in practice (Libert et al. 2017).

The creation of such programs leads to excellent results for health professionals, patients with cancer, and the families of the patients (Libert et al. 2017).

Internal medicine also has an important place for medical communication, especially with an lesser emphasis than something as serious as doctor-patient communication in oncology. Regardless, internal medicine still has an important place in the field of medicine. A study done by Maynard and Heritage looks at conversation analysis (CA) in a internal medicine standing. In the study, prior research was not widely available, until an increase in recent years (Libert et al. 2017). In addition, the study looked to optimize the interaction of doctors and patients further. In the study, the authors point out that conversational skills used in common places is directly used in doctor patient communication, and based off of that assumption, the studies conducted use a heavy criteria on regular conversation between normal people in a normal, non-medical setting.

In the research, Robinson and Heritage say that doctors tend to use more ‘soft’ language when correcting an resident if they make a mistake (Libert et al. 2017). This can also transition into how doctors interact with their patients. Patients, according to the study, will come into the clinical visit and diagnose their treatment to the doctor, and the doctor will use the same procedure that they use with residents in medical school (Libert et al. 2017).

Present-Day Technology and Medical Communication

Technology has allowed various industries to grow in the past few years, one being the medical field. Technology has allowed doctors to reach patients through various applications through the Internet, email, and other various online services. Technology has even been used to help give patients decision aids when it comes to making treatment plans for their diagnosis. In a study done by Kaner et al., the researchers look at paper based materials, which is the control group of the study, versus two electronic visual aids to compare and contrast the results of either (Kaner et al. 2007). In this study, however, it was concluded that paper-based materials were more efficient than electronic visual aids, with the electronic visual aids being slower for patients to understand and for doctors to understand as well (Kaner et al. 2007).

Another study was done by Kim et al., looking at the reliability of insulin dosing through a healthcare application on a phone. In this study, subjects were given three different sections to go through over a 24 week period: baseline, post intervention at the 12th week, and another a post intervention at the 24th and final week (Kim et al. 2017). The subjects are then divided into two groups, one sending in their health information manually, and the other group relying on algorithms used by the phone application, in order to monitor their insulin usage.

Based on the conclusions found in the study conducted by Kim et al., the group that used the mobile application to put in their glucose readings were more likely to keep a consistent track of their readings versus the group of people that did it the manual way (Kim et al. 2017) Conclusion

Medical communication is an ever growing field that is going to constantly change for many years to come. While technology in the field still has mixed responses, technology is going to play an important role in the future of medical communication. Certain mobile applications are able to help some patients keep track of their health information and vital signs, whereas the other side of medical communication, where visual aids are being used to communicate more efficiently with patients, has not been as effective as researchers had hoped.

Medical communication also has played a huge role in ethical situations in the past years, and continues to play a huge role, especially today. With the introduction of new edits being introduced to the Hippocratic Oath, ethics has changed the way medical communication has been looked at for years to come. Ethics shows doctors that, according to the research, in order to be better of a doctor, you need to be more personal with your patients to make more of an impact. Also, patients are more likely to tell you what is going on with them and this establishes a very trust-filled relationship between doctor and patient.

Medical communication is a part of one of the oldest fields on Earth, and it is something that will always change, yet it will never not be needed in society. Medicine will always be something that References

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