Author: Daniel Kamin

Hospital rounds: How’s the doctor-patient communication system?

(Andreas Gohr/Flickr)

When patients are sick enough to require hospitalization, medical decisions often involve nontrivial tradeoffs between risks and benefits. They require discussions with patients and families from a variety of cultures and backgrounds. And sometimes these discussions break down.

Patient-clinician communication is increasingly recognized as an integral part of clinician competency. Indeed, family-centered rounding, increasingly practiced at Children’s Hospital Boston, is a critical step in this direction. Fully adopting this practice surely will enhance communication quality.

Yet, I suspect we’re still missing cues from patients and families, signs that our alliances with them are not sound. We can’t be maximally perceptive all of the time. It is busy, we are tired, we want to teach, we want to be efficient, and we want to get to the noon conference to learn to be better doctors.

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Another training: “Difficult” patients

More than half of my work as a gastroenterologist at Children’s involves critical skills I never learned in medical school, residency or even fellowship. I enjoy using these skills and have been lucky to have some gifted mentors. But having these skills shouldn’t be dependent upon luck.

I am talking about bedside manner generally, but more particularly, about communication in the context of strong emotions.

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