Assessing effective physician-patient communication skills: “Are you listening to me, doc?”

The education of a physician includes much more than acquiring competence in medical knowledge and technical expertise. Physicians also need to have excellent communication skills in order to communicate with patients. Communication skills form the foundation for a more positive patient-provider relationship, leading to greater patient satisfaction and better patient compliance. In the patient’s eyes, the ability to communicate well forms a major component of a provider’s clinical competence. The ability to communicate effectively with patients can contribute significantly to improved patient outcomes. Because of their importance in the practice of medicine, teaching interviewing and communication skills are a part of the curriculum for medical schools. At the Mayo Medical School, a tool was developed to assist in the assessment of medical students when communicating with patients as they elicit a medical history. This rubric has been very useful for both teaching and assessment, and it may be applicable to other healthcare settings as well. Patients commonly complain that physicians do not listen to them. “Being a good doctor requires not only knowledge and technical skills, but also communication” 1. Communication skills are not just restricted to talking, but also to listening and nonverbal communication 2. Assessment of the provider’s ability to apply communication skills continues to be a concern of medical educators. Developing a positive relationship has historically contributed a great deal to a physician’s effectiveness and satisfaction within the profession 3. Such relationships are crucial for successful medical treatment 4. Good communication skills are a key to establishing these desired relationships, and the inability to display good communication skills has been shown to negatively affect many areas in patient care 5. On the other hand, good communication skills have been shown to improve patient treatment compliance, thus leading to improved patient outcomes 6. The benefits of good communication skills have been documented in the literature and recognized by physicians as early as Osler 7, who encouraged physicians to “care more particularly for the individual patient than for the special features of the disease.” Ludmerer 8 noted, “For over a century, the goal of medical education has been to produce thinking physicians, scientifically competent, who are sensitive to the emotional as well as the medical condition of the patient.” Unfortunately, there is evidence that suggests good communication skills are not universally practiced by physicians 5.