tag:blogger.com,1999:blog-2646672781891265261.post9191926557143239375..comments2023-10-07T12:47:43.024+00:00Comments on I'm a Medical Student, Get Me Out of Here: "Not The End Of The World"The Little Medichttp://www.blogger.com/profile/05743228690074334742noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-2646672781891265261.post-55989475248511855302008-02-20T22:49:00.000+00:002008-02-20T22:49:00.000+00:00Have personally been the patient of some surgeons ...Have personally been the patient of some surgeons with, erm "patchy" communication skills.<BR/><BR/>What the patients want, with reason, is skilled surgeons who are also good communicators. That is certainly the kind of surgeon medics recommend to friends and family "Oh yes, Mr X, he's an excellent surgeon AND he talks to his patients"<BR/><BR/>While a shit-hot surgeon who is a rotten communicator is preferable to the reverse for actually doing surgery, the problems I have heard of usually arose when it wasn't clear-cut that surgery was really the right course of action. Under those circumstances, the communication skills must be the key to sorting out if surgery is what the patient needs / wants - a classic example would be disc surgery for back pain. <BR/><BR/>If I have a bugbear with the surgeons I and my family have encountered as patients, it is that a few too many of them for comfort gave out a sense of being focussed on "Are you a candidate for my surgical list? Answer Y or N"PhD scientisthttps://www.blogger.com/profile/00653179299453839890noreply@blogger.comtag:blogger.com,1999:blog-2646672781891265261.post-53380912566744096262008-02-18T22:08:00.000+00:002008-02-18T22:08:00.000+00:00Communication is, obviously, key to what we do as ...Communication is, obviously, key to what we do as medics.<BR/><BR/>Whether it's getting information, explaining, advising, convenying info to colleagues, our world is all about communication.<BR/><BR/>Breaking bad news, usually, isn't instant. If someone's got uncurable pain/cancer/unwanted pregnancy or whatever, usually the communication is a process. So breaking bad news is part of that process, not one one off event. <BR/><BR/>If we're honest with our patients, breaking bad news can become a straightforward and easy part of our work. In part it may be because in psychiatry we're particularly communication focussed but even when I was a GP and when I worked in a hospice I found breaking bad news to be pretty straight forward and not a daunting or difficult task. As we're doing investigations we're honest, so after history/examination we're formulating "It may be infection, it may be inflammation, it may be something more serious." We send for baseline investigations, as results come back excluding stuff we're honest, "it could still be something simple, but we need to look for serious causes of this." On sending them for diagnostic confirmation, since it is confirmation, I'm honest and would say something like, "I'm prepared to be surprised, but it's likely that this is something serious so we're doing blah." Depending on the patient, vocabulary changes. Some need to hear words like "sinister" early on, some only want to hear "cancer" when it's certain, but the process of preparing them for the honest truth of it is best done as a process and not as a one off consultation.<BR/><BR/>RTAs and the like aside, most of our bad news is a longer term process which, with experience, you'll find your own style for. Done well, it's satisfying and a job well done. But don't sweat it, you need to cut your teeth before you can really get the skills.The Shrinkhttps://www.blogger.com/profile/10009039342346247138noreply@blogger.comtag:blogger.com,1999:blog-2646672781891265261.post-3541862721008672882008-02-18T21:40:00.000+00:002008-02-18T21:40:00.000+00:00Good communication skills is important - it makes ...Good communication skills is important - it makes the patient feel at ease and more relaxed which in turn help your build a rapport more quickly, the rapport is important because they need to trust you in order to tell you things, which are personal to them slightly embarrassing, and that they maybe haven't told anyone else. This has payback if/when you come to discharge a patient and you know more about their social situation and can help to get suitable support in place for their discharge.<BR/><BR/>In the community it is also important because if you build rapport quickly, and the patent gives you the information you have more time to discus the substantive issue and possible management and still complete the consultation within the 10 minute window!<BR/><BR/>Empathy is one of the few ways you can show you care about a patient. <BR/>The style of your Comms skills sounds quite odd, but it could just be that i am used to ours which is part of our vocation clinical and communications skills thread which runs through all 5 years, and involves numerous short consultations.Davidhttps://www.blogger.com/profile/06329448556395742786noreply@blogger.comtag:blogger.com,1999:blog-2646672781891265261.post-42308446001409859722008-02-18T18:00:00.000+00:002008-02-18T18:00:00.000+00:00I don't know how you define "better doctors" - I'd...I don't know how you define "better doctors" - I'd have thought good communication skills were an essential quality (one of many) to being a good doctor. I am sure to a certain extent it depends what type of doctor you are (good communication skills being central, for example to those working in psychiatry; arguably less central to those working in surgery) but I still feel communication is an essential skill for all doctors to develop. And I say that having been on the other end of both good and less than good communication!Disillusionedhttps://www.blogger.com/profile/03250678226289036634noreply@blogger.com