Communication checkup: How have you improved?

"People are complicated," Seattle-area family practice physician Dr. Sarah Kramer recently told Slate. "You may have a patient who doesn't just have diabetes--he's got diabetes, plus he's just gotten divorced and he wants to start dating again and is worried about sexually transmitted diseases."

That's one reason she's not worried about the likes of IBM's Watson or other technologies one day taking her job. Beyond the ability to make diagnoses and create treatment plans, physicians' most indispensable skills may be to get patients to talk, to read body language, to gauge their emotional state, assess their level of health literacy, and provide medical explanations and advice that connect. In other words: communication.

With Marcus Welby-type medicine falling further and further in the past, the medical community is slowly but surely realizing that it will have to relearn how to create the bonds like those fostered during a simpler time. Today, a physician's knowing every patient's by name without looking at the chart may not be realistic; but with competition at every corner, making a connection during the patient encounter is all the more essential.

The movement toward making physician-patient communication a priority is so prevalent, in fact, that the Agency for Healthcare Research and Quality (AHRQ) last week launched a new initiative to help improve such skills among patients and providers alike. According to a press release, the new initiative builds on previous public education campaigns AHRQ has conducted under contract with the Ad Council around the theme "Questions are the Answer."

The campaign includes not only a series of ads directed at clinicians but also a host of web videos aimed at patients demonstrating the power of asking questions in the medical setting. Through the website, patients can also create a printable question list for their doctors. Likewise, physicians can obtain cobranded notepads on which patients can jot down their top three concerns before an appointment.

It will remain to be seen whether these tools will help promote better two-way communication in the office. Will you use them? Will you recommend them to your patients? Where will you find the time?

Looking beyond the words exchanged between doctors and patients, a recent study out of the University of Michigan Health System explored the extent to which nonverbal communication from both patient and physician could influence medical care.

For instance, the research reaffirmed existing knowledge that patients often rate the encounter based on non-verbal clues that convey whether the physician appears hurried or at ease. And when patients get more positive cues from their doctors, the study found, they might be better listeners. As a result, doctors often discover the irony that to achieve genuine rapport with their patients, they may need to learn to fib with their body language. "I use my body a lot," one doctor reported. "It's nice to see that I don't look rushed in the room. Although in my mind, I'm whirling. OK, so I sit down, I try to relax and look relaxed."

The time conundrum is ever-present for physicians, but the need for doctors and patients to talk is not going away. Is this a skill set you've worked to foster in your physicians? What strategies have led to the most success? --Deb