Blog | Thursday, January 18, 2018

5 reasons communication is so often suboptimal in health care

Many of the everyday coalface problems we face in health care are simply due to suboptimal communication. It could be the patient or family member who doesn't know what's going on in the hospital, the nurse who is confused about orders, or the doctor who doesn't understand the reasoning behind the seemingly terrible administrative directive they are receiving.

Take it from me, as someone who has seen health care at close quarters on four different continents, this is a universal problem, and not a uniquely American one. So why is this? Why is health care notoriously so poor at times compared with other industries? Here are five reasons:

1. The fast-paced nature of health care

Medicine is an unpredictable and rushed environment, especially in the hospital. Physicians (and nurses) are rushed off their feet from start to finish, there are several things going on at any one time, and they have to multitask to the extreme. It would be wonderful to spend an hour with every patient, but that ain't realistically going to happen. In our ever-squeezed time slots (taking away the whole other discussion about bureaucratic and reimbursement reasons), we have to remain focused and to the point, and that inevitably means that there's not enough time to make sure everything is dealt with and explained as well as it could be.

2. There are too many things going on to keep track

In hospital, patients will be subject to tests, procedures, and a stream of different doctors seeing them. I've previously named this problem “Too Many Cooks in the Kitchen Syndrome”. If we consider too that most of our patients are on the older side, it's easy to see how things quickly become a confusing haze.

3. Complex problems that we are unprepared for

People don't plan to be sick. Even fewer people are well-versed in medical terminology and the decisions that have to be made during acute medical illness. It may also be unrealistic to expect that even a highly educated member of the general public, would understand everything that they are told by their physician. It's not like serving people food in a restaurant or fixing their sink.

4. Physician communication skills

A further aspect to this problem, that is not talked about nearly as much as it should be, is that physicians do not receive adequate communication skills training in medical school. What little amount of teaching that's given, is woefully inadequate to prepare for life as a “customer service facing professional” (and yes, whether doctors like the term or not, that is what we are). The same applies to nursing school curriculums and most other healthcare professionals: we simply don't put enough emphasis on the importance of solid communication in our everyday professional life.

5. Health care organizations have been slow to catch up

Health care institutions typically lag well behind other industries in applying communication and branding principles to their organizations. They frequently don't communicate their message to patients effectively, tell the right stories, and even their internal communication tree from administration downwards, leaves a lot to be desired.

The solutions to the above problems lie with a complete rethink within many health care organizations and a shift in internal culture. Simple common sense answers lie at the heart of most of our communication deficits in the trenches. As health care continues its tumultuous and ever-changing journey, we need to always stay focused on how we communicate with our patients (both at an individual and organization level). Their experience matters, and is crucial to their full recovery and motivation. It's not about satisfaction scores or meaningless tick boxes, but fundamental to delivering amazing health care.

Suneel Dhand is an internal medicine physician, author and speaker. He is the founder of DocSpeak Communications and co-founder at DocsDox. He blogs at his self-titled site here.