Doctors and the NHS were criticised recently for using “inaccessible language” by the Plain English Campaign.
The growth in management-speak in the NHS - with such phrases as “service users” and “disinvestments” - has the potential to confuse patients. A spokesperson for the campaign suggested that some doctors might also need to address the way they communicate with patients.
Most doctors recognise that the success of their relationship with patients is largely determined by their ability to communicate clearly and effectively. Doctors generally try to avoid using complicated medical terminology to describe medical conditions and treatments, but it is easy to forget that medical terminology may seem alien and off-putting to a layperson.
They may not understand what you are saying and failures in communication can translate into medico-legal problems. For example, patients who say they were not clearly warned about possible complications of a particular procedure are a common theme in complaints and claims notified to the MDU.
The GMC devotes a section of Good Medical Practice to communicating effectively with patients. It says that doctors must listen to patients’ views and respond to their concerns; explain to patients their condition and the treatment options in a way they can understand; respond to questions and keep patients informed; and ensure patients are informed about how information is shared among the healthcare team. It also says that doctors should ensure, “where practical that arrangements are made to meet patients’ language and communication needs”.
The following tips will help doctors avoid communication problems:
1. Try to explain your diagnosis, proposed treatment and any relevant risks to patients in a way they can understand and give them a chance to ask questions. If you wish to examine the patient, you must seek permission and will need to explain why it is necessary and what you intend to do during the examination.
2. While you talk, watch for appropriate acknowledgements and/or signs of any confusion. Remember, you understand medical terms that may mean nothing to many patients, such as anti-emetic or hypertension.
3. Try to resist the urge to interrupt but regularly acknowledge what patients are saying. To check that you understand what a patient has told you, repeat it back to them.
4. If a complaint is made, listen carefully. Before responding, make sure you understand the nature of the patient’s concerns. When providing a written response to a patient’s complaint it is important to use clear language to explain the treatment that was provided and the doctor’s clinical decision making in an attempt to resolve any misunderstandings that the patient may have.
6. If something has gone wrong, explain to the patient as soon as possible what happened, why it happened and what steps you have taken to prevent it happening again. Be ready to apologise, if appropriate.
7. The use of abbreviations should be avoided wherever possible, both for the purposes of clarity and ensuring patient safety when the records are used by other clinicians caring for the patient, and for the avoidance of doubt if these records are required later for medico-legal purposes.
The MDU has also launched Communication Skills for Doctors workshops to explore alternative and practical ways of thinking about communication with patients and colleagues.