Identifying Client Clues, Subtle Concerns Produces More Effective Diagnoses

—A report from International Communications Conference

Practitioners do themselves a disservice by interrupting patients and not asking for a person’s perspective on an illness, said Forest Lang, MD, a family physician and professor who has published a number of articles on medical communications. Lang presented different types of communication modules — including interactive and lecture — to veterinary practitioners and academicians during the International Conference on Communication in Veterinary Medicine.

The modules emphasized the importance of establishing common ground with patients (or clients) and ensuring that people are satisfied with the interaction, challenges that both veterinary and medical doctors face, Lang said.

Referring to “strong similarities between human medicine and veterinary medicine [patient] interviews,” Lang encouraged attendees to practice their ability to listen, ask questions, and engage clients during exams. “If patients are unsatisfied, you are not meeting their expectations,” he added.

Emphasizing that human and animal doctors struggle with similar communication challenges, Lang encouraged extra education in this area and referred to the International Conference on Communication in Healthcare, held earlier this month.  Cindy Adams, PhD, and Jane Shaw, DVM, PhD, presented materials at this year’s human medical communications conference.

While some doctors dismiss patient chatter as time-consuming, Lang showed evidence to the contrary. In fact, a growing body of research shows that patients lead doctors down the right path for efficient diagnosis with subtle clues.

“People communicate their deep concerns with clues,” Lang said. These clues may be implied or suggested, but doctors need active listening skills in order to identify them. In teaching settings, medical students continually fail to do so, he said.

Lang showed the audience video clips of exams with medical students and unannounced standardized patients to illustrate a doctor’s lack of attention to detail. The clips also illustrate how disruptive it is when doctors interrupt clients.

A patient’s reference to shortness of breath or leg pain intermixed with other information were missed by students in the video clips. These students interrupted patients several times to keep them “on track” and expedite exams, but Lang questions, “Is that a good or a bad interruption? Was that patient about to tell you something really important?”

Only time will tell.