Sunday 22 February 2009

Poor communication predicts complaints against doctors

But more importantly, predicts unhappy patients not getting the care they need.

An excellent patient experience (as measured by quality of communication from their physician) not only predicts quality clinical outcomes, but is important in protecting the doctor (and her organisation) from complaints and reduces the risk of litigation.

Of course all good doctors already know this and make monitoring and continually improving their communication skills a priority. It is interesting to see "early-adopters" amongst doctors now embracing web-based feedback from their patients as another tool to ensure excellence.

This JAMA paper from 2007 (JAMA. 2007;298(9):993-1001) describes a detailed, ten-year prospective study of complaints against doctors, and then performs regression analysis against their exam results in clinical communication skills. Final line of the conclusion is clear and powerful support to all who understand that an excellent patient experience is an integral part of excellent care, and not just a "nice to have":
"...the patient-physician communication score in the clinical skills examination remained significantly predictive of retained complaints (likelihood ratio test, P < .001), with scores in the bottom quartile explaining an additional 9.2% (95% CI, 4.7%-13.1%) of complaints."

Whilst communication skills are now an integral part of most medical schools' curricula, patient satisfaction scores are not increasing - is it time to make communication skills a core part of regular, re-training for all doctors?

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