PITTSBURGH Study targets skills of communication

Improving doctor-patient communication is essential, experts say.
PITTSBURGH (AP) -- Doctors have lots of advanced testing and medical devices to help them make a diagnosis, but technology hasn't replaced the need for a good bedside manner.
That's why the University of Pittsburgh School of Medicine has started a new institute to teach and conduct research on ways to improve communication between doctor and patient, joining a handful of such programs around the nation.
While medical schools teach students clinical skills, researchers say there's a growing interest in improving doctor-patient communication as the medical community stresses the value of interpersonal skills in providing palliative care.
"Despite all the scientific advances in medicine over the last century, sitting down and talking to patients is still the most common and one of the most effective things that doctors do," said Dr. Robert Arnold, director of the new Institute for Doctor-Patient Communication.
Topics planned
The institute hopes to go beyond just teaching medical students better listening skills by helping doctors artfully craft questions to elicit more complete answers from patients. Other research topics may include finding ways to encourage sexually abused women to come forward and whether doctors are dispensing enough information on heart disease, a leading U.S. health problem.
The American Board of Medical Specialties and the Accreditation Council for Graduate Medical Education have already made communication skills a core requirement for certification. And starting next year, the National Board of Medical Examiners, which administers the national licensing exam for doctors, will test medical students on their bedside manners.
Other communication programs have been established in medical schools, including the University of Rochester and Northwestern University, where director Gregory Makoul says the eight-year-old Program in Communication and Medicine has already resulted in changes at the medical school.
For example, researchers at the center found that doctors often make the mistake of focusing on the first problem a patient raises when, in fact, the patient may have other health concerns, Makoul said.
"When we looked at our videotapes, the physicians were not getting the patients' agenda upfront," Makoul said. "They would talk about a headache and not anything else."
Encouraging understanding
And since an estimated 90 million Americans have difficulty reading, physicians need to do more than write a prescription -- they need to make sure patients understand why and how they should take their medications, said Dr. Joanne Schwartzberg, senior scientist for the American Medical Association Foundation's health literacy initiative.
While the medical community often surveys patient satisfaction, Arnold said few studies have been done to find out how the relationship between a doctor and a patient can affect treatment and diagnosis.
For example, instead of asking, "What medications are you taking?," Arnold says it's better to ask patients to tell him about all the pills they are taking because some weren't giving him a complete answer.
"Many women don't consider birth control," Arnold said. "It makes a humongous difference to the diagnosis of the patient."