Mediators of Patient-Physician Communication Discrepancies

Abstract

later, Olson and Windish 1 show that this aspect of care is lacking. I am alarmed that such a high proportion of patients did not know their diagnosis on their day of discharge and were not aware of the possible adverse effects of new medications. It is little wonder that rehospitalization rates are so high when patients do not have basic information about their own medical condition and treatment. It has been shown that patients who do not have a clear understanding of their after-hospital care instructions are 70% more likely to be readmitted or visit the emergency department than patients who do. 3 This reinforces the importance of having good systems of communication between health care providers and patients.The fact that only 18% of patients could name their primary physician and that 56% felt that their physicians never discussed their fears and anxieties indicates poor interpersonal performance, not only by the physicians but by the multidisciplinary team as a whole. Interpersonal and technical abilities are 2 important elements of a health care professional's performance: "the interpersonal process is the vehicle by which technical care is implemented and on which its success depends." 4(p1744)Poor patient-physician communication is not limited to inpatient health care settings: in an outpatient, multicenter study, Weiner et al 5 found that physicians provided error-prone "care" in 78% of contextually complicated encounters. Physicians' care plans were inappropriate because they did not take into account environmental and behavioral factors affecting their patients' ability to carry out the recommended treatment.It is not a good enough excuse that health care professionals are too busy to provide effective and customized care plans for patients. Patient-centered care is everyone's business and needs to be systematically built into our health care systems. To create a culture of patientcentered practice, we require strong leadership at the macro and micro levels, and structures and processes are necessary to train and support multidisciplinary teams. There is increasing pressure on the health care system to provide timely, safe, effective, efficient, and equitable care. But what is the use if we do not empower our patients to care for themselves?

Patient Understanding and Impression of Hematology/Oncology Fellows

“…Another deficiency is the limited health literacy of a patient and the impact that it may have on the communication gap between patients and their caretakers. 9 In this study, only 20.6% of patients had completed a 4-year college degree, which may have played a role in understanding the situation at hand and the various people involved.…”

Survey of Patients Referred to a University Cancer Center for Benign Hematology: Quality Measures and Patient Understanding

“…6 Possible reasons are likely multifactorial, including lack of time as a result of busy schedules at referring physicians' offices and a lack of awareness among health care teams about possible anxiety and distress that may be experienced by the patients. 6 Possible reasons are likely multifactorial, including lack of time as a result of busy schedules at referring physicians' offices and a lack of awareness among health care teams about possible anxiety and distress that may be experienced by the patients.…”