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                         JeffNEWS, June 7, 1994
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Good Communication Skills of Physicians Are More Important Than Ever Before
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   Admittedly, medical knowledge and clinical skills are the
cornerstones of good patient care. Still, what needs to be emphasized to
medical students and physicians is that the catalysts for transforming
good patient care into effective patient care are the communication and
interpersonal skills of physicians.

   This will be especially important in the future as healthcare system
reforms unfold and more managed care situations arise. One of the
criteria some managed care organizations ask patients to assess is the
communication skills of their physicians. Those physicians determined to
have poor communication skills face the possibility of being dropped by
the organization.

   The need for physicians to communicate better with each other, with
their patients and with people outside the medical profession takes on
added urgency in light of the social and political changes that will
surely affect the medical practice environment and the delivery of
medical care for years to come. 

   A major way that physicians communicate, of course, is by writing. 	

   The ability to write clearly and logically is recognized as an
important and desirable skill for physicians to possess. Unfortunately,
with some outstanding exceptions, it seems to be a professional skill
more honored in the breach than in the attainment. 

   If you talk honestly with enough people outside the medical
community, you will find that their biggest problem with doctors is
communication. Repeated criticisms of physicians' writing skills speaks
to a lack of clarity in much of what physicians write. Confused and
convoluted writing by physicians can be a danger to patients and others
because meaning and content can be misinterpreted or misunderstood.

   Developing acceptable writing skills, then, should be a major goal
for physicians because the nature of the medical profession is such that
physicians cannot escape the need to write, be it a patient's medical
record, a letter to a referring physician, a progress note on a hospital
chart, or an article for submission to a medical journal. The content
matter of what physicians write must be clear, and incapable of being
misinterpreted or misunderstood because, quite often, what doctors write
concerns itself with critical issues, such as the health and welfare of
a particular patient, or a group of patients.

   Despite its clear importance, writing receives little prominence in
the traditional medical school curriculum. Hopefully, this will change
as innovative medical colleges like Jefferson give increasing attention
to non-clinical educational topics that benefit residents and other
doctors.

   My decision to write a book for other physicians on writing and
communication skills reflects this curriculum need. When I taught a JMC
elective course on writing, I could not find a physician-level text on
the subject. To supplement my teaching I compiled my own handout
material which I eventually expanded into a class manual and then into a
published book. I hope it will be used by medical colleges electing to
include this important communication topic in their curricula.

   The medical profession can ill afford to lose the support of patients
and the public as debates about the future of health care continue.
Enhancing physicians' interpersonal and communication skills will help
foster that support and have a positive impact on patient care outcomes.

Editor's Note: John J. Gartland, MD, was chairman of Jefferson's
department of orthopaedic surgery from 1970 to 1985. He is author of
Medical Writing and Communicating, published in 1993 by University
Publishing Group, Frederick, Maryland, from which part of this column is
adapted. Devoted entirely to medical writing techniques and
communication skills, his book is believed to be the first one published
on the subject written by a practicing physician for other physicians. 


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Information provided by:  Editor, JeffNEWS
                          (215) 955-6204
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