Communication for doctors: How to improve patient care and minimize legal risks

Edited David Woods . Radcliffe Publishing Ltd , 2004 , PB £21.95 , 125 pp . ISBN 1 85775 895 1 This text is an eclectic collection of distinctly individual essays that aim to provide physicians with advice on improving a wide variety of communication behaviours. Several chapters are quite useful, focusing on important aspects of physician practice. Particularly helpful are chapters by Susan Keane Baker who offers practical tips on issues including informed consent, telephone etiquette, office environment and systems improvement, and dealing with angry, complaining patients. Several chapters by lawyer James Saxton also provide important information about medico-legal issues and the significance of communication in minimizing legal risk. A number of chapters by the editor, David Woods, illuminate important issues including the language of healthcare, the physician's professional image, and the dangers of euphemism. Other valuable chapters by Woods address the importance of liberally educated physicians, physicians’ professional image, advice for medical interviews, and the role of office staff in promoting effective relationships with patients. Like a self-help book, readers will gain most from this text by choosing those chapters pertinent to their needs. Although the overall intended audience for this work is clearly doctors, some chapters may be more appropriate for office managers or others working in the physician's practice. Readers are encouraged to share these specific chapters with appropriate office personnel. For example, ‘Seven ways to build trust with your patients on their first visit’ would be an excellent chapter to share with staff or to use as a basis for discussion in a staff meeting. The chapter ‘Take two aspirin and call me in the morning’ may be a helpful patient education tool. Patients and patient advocates may also find certain essays in this text both helpful and interesting. Certain strategies described for improving communication for physicians may also serve to empower patients. Patients who know what to expect from physicians become more informed consumers, and patients who understand what physicians are trying to accomplish can actually help facilitate the process. Empowered patients may also contribute to the improvement of medical practice by identifying, complimenting and thereby reinforcing practice that is consistent with suggestions presented in the text. Most of the essays included in this text are entertaining and light, but as a whole they are somewhat uneven. Some are rather preachy in tone and yet others read like a business text. Further, there is occasional redundancy between chapters. Although practical solutions are often provided, these solutions are frequently lacking theoretical background and scientific evidence as much of what is presented throughout the text is personal opinion. Some chapters, like those by Julia Schopick, are largely based on personal experiences, and, although interesting, can be viewed as idiosyncratic. Finally, some suggested activities – like arranging to consult with a researcher to assess information brought in by patients; running focus groups with patients; or setting up a newspaper clipping service – might be possible for some but impractical for many practicing physicians. Within the text there are several essays specifically focusing on medical writing and publishing. These essays, mostly authored by the editor, are sometimes straightforward and other times rather clever and lofty. These particular chapters will be of interest to physicians who want to submit manuscripts for publication, but may be of less interest to others. The chapter entitled, ‘How about a hippocratic oath for patients’ appears to be an attempt at irony by the editor. This lighthearted treatment of patient behaviour, however may, undermine the effectiveness of other important messages in the book including those in the subsequent chapter that stress listening, understanding and appreciating psychosocial consequences of illness. As an international publication, many chapters seem to have universal appeal. These are the chapters that focus specifically on doctor–patient communication. Because the business and structure of medical practice varies from one country to another, chapters about systems-level or even practice-level issues may need to be interpreted and variously applied. Also, chapters on medico-legal concerns may not translate directly to other countries and medical care systems. With the exception of one Canadian, all chapter authors are from the USA. The editor, David Woods is based in Philadelphia, PA, USA. Thus the text has a definite North American spin to it. Yet overall, this is an entertaining and often helpful book for physicians and perhaps others interested in communication between doctors and patients. Selectively read, valuable lessons will be found and helpful advice gleaned. Certainly the various authors represented throughout the text provide an interesting assortment of perspectives and opinions on issues and aspects of medical communication.

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