Q: You decided to move to Costa Rica for a time in large part to improve your Spanish so you could communicate better with many of your patients. Language differences aside, would serious improvements in our ability to communicate–in doctor/patient dialogue–be as important to largely successful healthcare as improvements in medicine?
Health care has improved vastly over the decades, due to technological advancements and an impressive body of medical research. However, if doctors and patients can’t communicate, all of that technical prowess is for naught. If doctors aren’t skilled enough to elicit from patients their deepest concerns, all the medical care in the world will be useless. If the conversational environment is such that patients don’t feel comfortable opening up about awkward, personal, and sometimes embarrassing issues, then these patients will not be helped.
This is particularly the case for issues such as depression, sexual dysfunction, domestic violence. But even “routine” illnesses such as diabetes, hypertensions and heart disease are profoundly affected by the quality of doctor-patient communication. For example, if a patient isn’t taking their medications and is not comfortable admitting this—perhaps because the side-effects are embarrassing, or they are unable to pay for the medications—these diseases will not be adequately treated. The patient’s health, and life, is at risk. Good doctor-patient communication is arguably the most powerful medical tool in our arsenal.
Danielle Ofri is a physician at Bellevue Hospital and an associate professor of medicine at N.Y.U. School of Medicine. Her newest book is What Doctors Feel: How Emotions Affect the Practice of Medicine. She is also editor-in-chief of the Bellevue Literary Review.