Today's physician is busier than ever before. Managed care headaches, too many patients, electronic medical records, and other emerging technology make some physicians feel that they simply don't have enough time to communicate with each patient. According to Dr. Peter Barnett, an internist and assistant professor at University of New Mexico, "the time you spend up-front frequently saves time later [in the form of] phones calls, questions and complaints."*

Improving communication with patients has clear benefits in reduced risk for malpractice suits, improved physician satisfaction, and better patient understanding of conditions and treatments leading to greater compliance. Medical schools are beginning to address communication in their curricula, but what about the physician who is far out of medical school? Here are five simple ways to start.

1. Put Down that File or Tablet PC!

Non verbal behavior often communicates things we have no intention of communicating. You may be able to fully attend to a patient while reviewing and making notations in their charts or on your computer, but you are communicating that what they are saying is not important enough to give your full attention. Make eye contact with the patient, be aware of how you are holding your body (uncross your arms, lean forward) and, most importantly, don't interrupt. 2. Be Human

My son was born premature and had some medical issues for the first few months of his life. We had an amazing pediatrician at the time. Though she had extensive medical knowledge, the reason we trusted her was primarily because she made herself so human to us. She decreased the power differential by telling us that she prayed about our son at night. When discussing decisions that needed to be made, she indicated which choice she would make if it were her child, she knew how to joke and keep things light when needed, and just through casual conversation during appointments we knew little things about her family and interests. Even when working with patients, she was a person first and then a doctor.

3. Show Compassion/Empathy

Many people may think that being empathetic and compassionate are traits that can't be learned. I believe that most physicians have these traits or they would not have chosen their line of work. They often just need work with the skill of showing it. Actively listen when patients are talking to you. Increase your comfort with feeling words and expand your emotional vocabulary. Try to listen for what they may be feeling or think about what you may feel in a similar situation. Use the formula "I can understand why you would feel _______. Is there anything I can do to help with that?" You may actually be able to provide a solution be it literature, a different prescription, clarification, reassurance, or support.

4. Clarify

One common communication error physicians make is to talk at the patient, rather than discuss the situation with them. We understand that this may be the 30th case of the flu you've seen this week, but to the patient, it's unique. What may seem very clear and simple to you can be extremely confusing for your most educated patients. After explaining something to a patient, ask for their understanding of the situation. Practice the same strategy yourself and summarize the patients concerns or questions that they present to you.

5. Increase Self-Awareness

Practice the skill of self-observation. Learn the strengths and weaknesses in your personality. Be aware of your style, habits, and tone. Note how you communicated after people responded positively and negatively to you. Ask a trusted friend, family member or professional advisor for an assessment of your verbal and non-verbal communication skills. By increasing your self-awareness you will be able to pinpoint the areas of communication you want to consciously improve.

Not surprisingly, physicians who lack effective communications in the workplace will often have issues in their personal lives, such as strained relationships with children, marital problems, divorce, and dating difficulties. Learning to communicate effectively can lead to dramatic improvements in one's quality of life from both a professional and a personal perspective. Incorporating these new skills consistently can be difficult and outside help is often useful.

*"Bedside Manner for the Modern World" Joanne Tetrault PHYSICIAN PRACTICE October 2005