Communication: a vital component of highly effective patient care

Communication: a vital component of highly effective patient care

Dec 01, 2004

Most would agree that there is an art as well as science to the practice of veterinary medicine. Under which of these categories would you place the skill of communication? Whether one thinks of communication as an art or science, or both, one fact is certain: We could not practice veterinary medicine without communicating with others. How we communicate with our clients can be a source of mutual understanding and positive action or a source of misunderstanding and frustration. In this context, communication is a vital component of providing highly effective patient care.

In terms of communication, rate the following components, in your opinion, as most important: listening, speaking or understanding? Before answering this question, please consider the following points.

Listening Effective communication involves more than mastering speech. It is also vitally linked to our desire and ability to listen. Although all of us have had formal training in how to read, write and speak effectively, how many of us have received a balanced training program on how to effectively listen? For most of us, listening is a skill that we acquire informally. Our lack of training in the skill of listening is ironic when one considers that in our role as veterinarians, successful communication with our clients is dependent on our ability to listen and understand their needs and feelings in addition to speaking in a way that they will understand us. In fact, the first step in collecting diagnostic information typically begins with listening to our clients while they describe their concerns. Good listening skills are not only essential for accurate evaluation of a patient's illness, they convey our sincere interest in the overall welfare of the client and patient. Therefore, in addition to developing our IQ's, we must develop our EAR-Q's.

When beginning to listen to our clients' concerns, what should be our primary motive for doing so? Should we listen to them primarily with the intent to reply? If so, we are practicing reactive listening. Reactive listening encompasses responses that interrupt, probe, interpret and advise? When we reactively listen, we often provide responses that convey our own point of view about our clients' concerns. This may be categorized as the "doctor-centered component of the clinical interview." But isn't this our primary goal? Isn't it true that if clients are seeking our expert advice in our role as veterinarians, then they should be listening to us for our recommendations? Before you answer these questions, please consider your personal experiences with physicians.

Have you ever felt that physicians you consulted for help with an illness didn't take the time to listen carefully to your concerns before making a diagnosis and recommending therapy? Have you experienced encounters with physicians whose controlling style of inquiry about your concerns felt more like an interrogation than a conversation? If your answer is "yes", then you are not alone. For example, in one study physicians interrupted 69 percent of their patients before they could complete their opening statements in effort to direct questions toward a specific concern. The mean time to the first interruption was 18 seconds. Once interrupted, fewer than 2 percent of patients went on to complete their statements (Beckman et al: Annals Internal Medicine, 1984, 101: 692-695). If the doctor responded to your concerns without really understanding them, how did you feel? Now, contrast this feeling to when a physician took the time to listen to you with the intent of understanding your concerns. What is the point? Failure to listen with the intent to understand our clients' feelings and viewpoints can be a major obstacle to further communication. In fact, many clients might loose confidence in our desire to help them. Furthermore, many clients won't care about how much we know until they know how much we care. To some, caring is more important than curing.