WHAT makes a good doctor? Various factors play a role — the ability to think critically and quickly on one’s feet, knowing when to ask for help, being safe, constantly updating one’s knowledge and skills — the list goes on.
There is no one single answer, of course, and it’s usually the whole that is greater than the sum of its parts.
Having said that, all stakeholders will agree that good communication skills rank as one of the most important criteria in not only being a great doctor, but ensuring that patients receive the best possible outcome. This is not just true intuitively, but is borne out by a large and compelling evidence base in medical literature.
By the time a medical student graduates, he or she would have learnt the equivalent of an entire language. It requires new sets of skills to communicate the novel words and phrases that one comes across in an effective and efficient manner.
More importantly, it is essential that these terms are translated into non-medical jargon when dealing with patients and are used appropriately when talking to fellow healthcare professionals.
However, communication skills is more than just the mastery of words. It is about looking and sharing non-verbal cues, listening actively and showing empathy. It sometimes requires a paradigm shift in which doctors view patients as partners, a shift away from the old paternalistic notion of patients as subordinates.
Communication is about giving and receiving information from patients in a clear and concise manner with the right attitude. It starts with understanding the type of communicator you are, and adjusting your approach depending on the patient, family member or situation you are facing.
Different methods need to be used when dealing with an angry patient, a depressed patient, one who is blind and unable to appreciate your verbal cues, or patients who come from different cultures and socio-economic backgrounds.
Communication skills are also important between healthcare professionals. Sometimes, it is about the simple things — being courteous to junior staff or other members of the profession.
Sometimes, it can be more complicated — knowing how to question incorrect decisions by seniors or accepting constructive criticism by others. At a more advanced level, it is about presentation skills during ward rounds and/or international conferences.
The importance of communication skills is drilled into us at a very early stage when it comes to handing over cases. Catastrophe can occur if one doctor gives incorrect information to another, especially if there is too much distraction and noise in the lines of communication, as is often the case in hospitals.
Healthcare workers rehearse many formal forms of handover, such as the SBAR approach of highlighting the Situation, Background, Assessment and Recommendation, because systems have to be put in place to minimise risks to patients.
In this day and age, doctors also need to be aware of the etiquette of communicating digitally. There are ethical considerations to be taken into account when using social media, nuances of a patient’s condition may be lost when using telemedicine, an inaccurate impression may be relayed when a patient received a monosyllabic answer from the doctor on the other end of the line.
Patients can be educated through Facebook or websites, just as feedback can be given to doctors on their performances.
The increasing ubiquity of artificial intelligence further increases the importance of communication skills and emotional intelligence. A recent paper in the Harvard Business Review stated: “Those that want to stay relevant in their professions will need to focus on skills and capabilities that artificial intelligence has trouble replicating — understanding, motivating, and interacting with human beings. A smart machine might be able to diagnose an illness and even recommend treatment better than a doctor. It takes a person, however, to sit with a patient, understand their life situation (finances, family, quality of life, etc), and help determine what treatment plan is optimal.
“It’s these human capabilities that will become more and more prized over the next decade. Skills like persuasion, social understanding and empathy are going to become differentiators.
“Unfortunately, these human-oriented skills have generally been viewed as second priority in terms of training and education. We’ve all experienced the doctor or consultant who is more focused on his or her reports than on our unique situations and desires.”
Communication skills are more than just about passing an exam or knowing a language. Honing it requires a formal, apolitical, holistic approach to ensure that trainee doctors are fit for purpose, ready for the future and ultimately provide the best care possible for the rakyat.
Dr Helmy Haja Mydin is a consultant respiratory physician and co-founder of Asthma Malaysia, a patient advocacy group (www.asthmamalaysia.org)