Communication in Medicine: Looking With the Eyes of the Receiver

Clarity in communication: that is what it is all about particularly when communication is involved within the critical specialties such as the air controller, the police and other emergency services and so many other interactions between someone who has important information and someone who should know but also understand as fully as possible that information as presented. The other examples include that of the medical profession.

As one example, I teach medical students how to take a history and perform a physical exam and how to write it up, I repeatedly find that students tend to write but really not read what they have written. This lapse leads to the possibility of the medical bloopers which are exampled on a previous thread. For the uniformed reader of a medical record written by someone who hasn’t read their own writing, confusion and possible error can abound. I emphasize to the students the need to read what they wrote but with the eyes of that uninformed reader. Does what is written tell the whole story or are parts so abbreviated that significant parts known to the student are missing? Does the written description of symptoms or their relationships or treatments, in the patient’s own words make sense? If the student doesn’t understand what the patient means, it may well be that the uniformed reader of the medical record will also fail to understand. Unfortunately, as the student’s career continues, the time available for re-reading and review of what is written will become limited yet the importance will not be diminished.

Another profession where clarity in communication is very important but has been found to be faulty and should be improved is that of healthcare journalism. Susan Dentzer, who is editor-in-chief of Health Affairs, Bethesda Maryland and an on-air analyst on health policy for the NewsHour with Jim Lehrer on the Public Broadcasting Service, has written an article “Communicating Medical News — Pitfalls of Health Care Journalism” in the January 1st 2009 issue of the New England Journal of Medicine which is available to read free at this link.

Susan gives examples of incomplete, inaccurate and misleading communication to the public by some reporters of medical “news”. The consequences can be that some members of the public may make unhealthy and unwarranted personal medical decisions based on their understanding of what they were informed. Particularly important is that the reporters become educated in some of the technical details of the stories they write, take broader and more complete views of what they are reporting and finally consider with the eyes of the public what they are writing or talking about. Susan writes “Journalists could start by imposing on their work a ‘prudent reader or viewer test’: On the basis of my news account, what would a prudent person do or assume about a given medical intervention, and did I therefore succeed in delivering the best public health message possible?”

It is my opinion that failure to deliver an accurate, balanced and realistic message as either physicians or journalists do their jobs only adds to confusion and misinterpretation by those who are expected to receive it. And such consequences can easily be detrimental to effective healthcare. My advice to doctors or journalists: communicate with care. ..Maurice.
ADDENDUM:
Graphic: A photograph of a garlic which I took. The text is mine..to make a point on what you might get in a medical news film clip on TV. But there is some truth in what I wrote though you wouldn't know it without getting ALL the facts. You have that chance to learn the facts by going to this link to the American Academy of Family Physicians website.