Communications and Interpersonal Skills

A recent commentary in JAMA, “Patient-Physician Communication: It’s About Time,” (Levinson W & Pizzo PA, May 14, 2011, 305:1802-3) highlights the apparent benefit of clear physician communication on patient outcomes. Communication and interpersonal skills are one of the Miller-Coulson Academy’s domains of clinical excellence. The JAMA commentary points out how these skills, which take time to teach and to practice, tend to be undervalued in medical schools, residency programs, and academic medical centers in general; especially in comparison to scientific knowledge and medical technology.

“Although time to listen to patients and teach communication skills may be scarce, technology is plentiful. Academic medical centers almost worship technology.”

In their commentary, Levinson and Pizzo urge academic medical centers to take the lead in assigning value to patient-doctor communication. Although these skills may be more challenging to measure, they remind us that metrics are available and suggest these skills be assessed in clinicians and even tied to financial incentives. In this way, physicians would be recognized for spending more time with patients instead of less, as opposed to the current system that rewards physicians based on the number of patients seen in a given amount of time. The authors close with a statement evocative of David Hellmann’s reminder to us that medicine is a public trust and a call to renew our commitment to that trust:

“If the medical profession wishes to maintain or perhaps regain trust and respect from the public, it must meet patients’ needs with a renewed commitment to excellence in the communication skills of physicians. It is time to make this commitment.”

The Miller-Coulson Academy of Clinical recognizes communication and interpersonal skills as a pillar of clinical excellence. In his recent Miller Lecture on this campus, Peter Pronovost called us all to act to improve the quality of patient care. By operationalizing, teaching, measuring, and incentivizing of these skills, as well as demonstrating their impact on patient outcomes, the Academy could reinvigorate the practice of compassionate patient care.

A link to an extract of the JAMA article can be found here

Margaret S. Chisolm, MD

Assistant Professor

Department of Psychiatry and Behavioral Sciences

Johns Hopkins University School of Medicine