Communication and listening skills in healthcare professional practice

Health Care Roles in Communication

Communication is a fundamental piece of health care education and has been shown to improve health outcomes, patient compliance, and patient satisfaction. Quality health care emphasizes knowledge and utilization of communication skills. Health care professionals often express anxiety and lack of confidence and are deficient in a creating a situations that are conducive to open and candid communication with patients (Kameg et. al., 2009).

Effective communication involves gathering information, establishing a relationship or connection with a patient, and supporting the person through words and other non-verbal forms of interactions. Effective communication involves not only the interactions between the staff and the patient but also the interactions between staff and the interactions between the staff in front of the patient. Many times the high demand for services in a health care facility cause the staff to overlook the importance of good communication skills and enables situations to arise that can be uncomfortable for all parties.

Communication failures are increasingly being implicated as factors influencing patient safety. Today medical care involves shorter hospital stays, increased patient acuity, and coordination of care by numerous specialists. These complex changes affect both health care professionals and health care educators and have made it necessary to ensure that health care possess the knowledge and skills to effectively communicate with patients, their families, and other members of the healthcare team (Kameg et. al., 2009).

Listening

Clinical psychologist Larry Nadig (2010) notes that expressing our wants, feelings, thoughts and opinions are clearly only half of the communication process. The other half is listening and understanding what others communicate to us. When a person decides to communicate with another person, he/she does so to fulfill a need. The person wants something, feels discomfort, and/or has feelings or thoughts about something. In deciding to communicate, the person selects the method or code which he/she believes will effectively deliver the message to the other person. The code used to send the message can be either verbal or nonverbal. When the other person receives the coded message, they go through the process of decoding or interpreting it into understanding and meaning. Effective communication exists between two people when the receiver interprets and understands the sender's message in the same way the sender intended it.

Non-verbal Communication

A third aspect of communication is non-verbal. Non-verbal communication involves those non-verbal stimuli in a communication setting that are generated by both the source (speaker) and his or her use of the environment that have potential message value for the source and the receiver (listener). Essentially it is sending and receiving messages in a variety of ways without the use of verbal codes (words). Non-verbal communication can be both intentional and unintentional. Basically there are two types of non-verbal communication, messages produced by the body and messages produced by the broad setting that is time, space, and silence (Segal, Smith, & Jaffe, 2010).

Communicating through the Environment

The interior design of a doctor's office conveys many messages to the patients. Since the interior of doctors' offices are the first things patients see, the space needs to express the professionalism and expertise of the doctors and make the patients feel comfortable. The right kinds of furniture, pictures and lighting can reduce the stress of the visit. Decorations such as beautiful artwork, photographs, calming paint colors, and comfortable furniture can help to put patients at ease. Interesting objects such as aquariums and plants can also be soothing, distracting patients from their possible aliments (Shea, 2007).

Scenario Overview

Vivian is a woman of undisclosed age who has been suffering abdominal pains for approximately one week. She has just taken a new job with health insurance and is able to an appointment with the doctor. Upon her arrival she finds the office decorated with gray walls, black chairs and two notices on the wall instructing patients to "Turn off cell phones" and "Have co-pay ready."

After signing in she is begins to tell the receptionist about her medical concerns, but is interrupted and instructed to have a seat. Immediately thereafter another patient is called to the receptionist's desk. Eventually Vivian gets in to see the doctor, Walls, who "talks as if he is in a race." Dr. Walls quickly examined Vivian without allowing her an opportunity to fully explain her symptoms. He then gives her a possible diagnoses, an ulcer, with no explanation of her prognosis, prescribes medication for pain, and instructed to set up another appointment for an ultrasound. As the doctor starts to exit the examination room he asks if she has any questions. However, the pace of the examination has left her little time to formulate her thoughts and the doctor leaves without allowing Vivian ample time or opportunity for a consultation.

Communication Implications

Health communication includes the study and use of communication strategies to inform and influence individual and community decisions that enhance health care. It connects the domains of communication, and health and is increasingly recognized as a necessary element of efforts to improve personal and public health. Health communication can contribute to all aspects of disease prevention and health promotion including: 1) health professional -- patient relations, 2) individuals' exposure to, search for, and use of health information. 3) individuals' adherence to clinical recommendations and regimens, 4) the construction of public health messages and campaigns, 5) the dissemination of individual and public health risk information, 6) images of health in the mass media and culture at large, and 7) the education of consumers about how to gain access to public health and the health care system (Health Communication, 2010).

In the above mentioned scenario, both Vivian's perception of the physical environment of the office and her contact with the receptionist and doctor could potentially exacerbate her condition. The objectification of Vivian by both the receptionist and Dr. Walls does little to encourage her to seek further medical treatment. Her future expectations of the entire health care system could easily be shaped by the lack of support she experienced in Dr. Walls' office. This could lead to unwillingness to divulge information that might be helpful in future visits to the doctor to properly diagnose illnesses or other medical conditions. The negative social and physical context as well as the verbal and nonverbal communication which were not conducive to her well being, might very well result in a reluctant attitude, inhibit compliance, and manifest trust issues with personal information which may be vitally important.

An Appropriate Resolution

It is evident that Dr. Walls' receptionist has adopted his persona. In order to improve his practice the doctor must gain an awareness of the needs and expectations of his patients, and he then must decide that the effort to meet these needs and expectations is worthwhile. The culture in the office must be reformed beginning with Dr. Walls himself, and then the staff. Furthermore it would behove his patients to change the physical environment of his office to ease the stress that many clients feel when seeing a doctor.

The adaptation and incorporation of effective communication techniques can go a long way in enhancing and promoting open collaboration and communication between patients, doctors, caregivers, family members, friends or staff working at any healthcare facility. Effective medical treatment includes the commitment to understand patients and their point-of-view, ideas or concerns. When a patient feels understood it gives an affirming and validating feeling thereby influencing change which can lead to higher quality health care. The development of listening skills may be the most significant communication factor in improving patient outcomes. Better communication skills from doctors' and their staff's means being able to listen and think before speaking in determining a patient's situation. This provides a supportive environment where the patient's personal coping ability and confidence is enhanced and simultaneously helps healthcare establishments to operate in an effective manner (Gamble & Gamble, 2006).

Conclusion

It is ironic that often the people with the greatest health care needs often have the least access to information, communication technologies, health care and supporting social services. The most carefully designed health communication program will have little effect if underserved community members lack the ability to utilize services. Research indicates that even after targeted health communication interventions low income and low educated groups remain less knowledgeable less likely to change behavior than their counterparts. This knowledge gap leaves many chronically uninformed.

Furthermore, even with access to information and services this group remains at risk due to a lack of health literacy. Health literacy is increasingly important to help individuals make their way through a complex health care system. The ability to read and understand materials related to personal health issues contributes to this gap (Health Communication, 2010).

Nevertheless, heath care professional have an opportunity to close this gap by developing a high quality, audience appropriate information and support system for specific health issues aimed at all segments of the population. Training health care providers in the science and techniques of effective communication and the use of communication technologies will help to promote a crucial understanding for this underserved population. Health care professionals need to develop a high level of interpersonal skills in order to interact with diverse populations and patients who may come from a variety of different cultural, educational and socioeconomic backgrounds.