Communication in Medical Therapeutics

Abstract

Success in inedical therapeutics depcntls heavily upon whether the doctor and patient adequately communicate their expectations o f one another. Communication serues as the mechanism for the necessary, constant reliegotiation of their interpersonal contract if the therapy is of more than brief duration. This implicit contract is necessary for assuring a sufficiently equitable, gratifying relationship that each will do hi.T part to accomplish therapeutic success. This paper discusses characteristics of effective doctorpatient communication, the process of "spiraling down" or progre,ssive failure of communication, and the manner in which snch a process may be reversed. lmmediate attention needs t o be given to the teaching of communication principles in programs of medical education.A great deal has been written about therapeutic communication by Jurgan also others who are concerned with the psychotherapies. These publications have extensively developed the central theme that communication is the principal tool and the core process by which a professional helps a patient with a psychosocial problem to change his thinking, feelings, and behavior.In this paper we would like to use the term therapcxtic communication in a broader sense. We propose that in the practice of all human therapeutics (including those of medicine and surgery, dentistry, nursing, speech therapy, and others ) the effectiveness of communication between the participants in the system is a major determinant of whether that therapy succeeds. Success in therapy, we also suggest, refers appropriately to attaining not only the goals of the therapist but also those of the patient. Although the doctor-patient relationship has often been considered in detail, the communicative process has received little attention as one of many factors that substantially influence whether the goals of medical therapeutics are likely to be accom. plished.' THE CONTEXT OF' THERAPEUTICSIn all therapies, the central goal is the arrest or cure of a malady, improvement in biological or psychological functioning,

Relational communication in health care

“…For example, five different topic areas of such research include: 1) low levels of patient compliance have been linked to the failure to establish effective provider/patient communication relationships (Charney,1972;Dimatteo, 1979;Lane, 1983Lane, , 1982Stone, 1979); 2) miscommunication and misinformation in health care have been related to inaccurate interpersonal interpretations, ineffective and manipulative message strategies and failures to seek and utilize interpersonal feedback between health communicators (Golden and Johnson, 1970;Ley, 1972;Waitzkin andStoekle, 1972, 1976); 3) insensitivity in health care has been related to low levels of interpersonal respect, attempts for relational control, and inability to accurately interpret nonverbal messages (Daly & Hulka, 1975 Deuschle, 1967;Korsch, Gozzi, and Francis, 1966;Korsch and Negrete, 1972;Lane, 1982); 4) unrealistic and unfulfilled patient expectations have been linked to cultural stereotypes, misinterpretations of relational needs, and inflexible relational role performances (Blackwell, 1967;Fuller & Quesada, 1973;Mechanic, 1972;Myerhoff & Larson, 1965;Walker, 1973); 5) dissatisfaction with health care by both providers and consumers have been tied to failures to express interpersonal empathy, relational dominance, and dehumanization (Ben-Sira. 1976; Kane & Deuschle, 1967;Korsch, Gozzi & Francis, 1968;Korsch & Negrete, 1972;Lane, 1983;Street & Wiemann, 1987).…”

Interpreting Information

“…Fisher and Todd (1983) indicate that the provider and patient bring different expectations into the medical encounter. Fuller and Quesada (1973) elaborate further that the success of the interaction depends on the ability of the provider and patient to communicate their expectations. The data generated from the theory of interpreting information support these findings and suggests that the situation is even further compromised when individuals in the medical encounter come from cultures with diverse expectations.…”

“…Orl whether the physician and patient communicate their **Sectations to each other (Fuller & Quesada, 1973). The **lationship between the physician and patient proceeds *Scording to a prescribed social direction embedded in the c.c.ratext of medicine (Clampitt & Williams, 1979).…”

Empathic listening test: An instrument for the selection and training of telephone crisis workers

“…The context of that relationship is termed a therapeutic environment. The creation of a therapeutic environment may be viewed as a system of communication and the effectiveness of this communication between participants in the system determines the outcome of therapy (Fuller & Quesada, 1973). The role of communication in the practice of all human therapeutics is well established (Rogers, 1965;Ruesch, 1961 ;Watzlawick, Beavin, & Jackson, 1967).…”