Physician communication styles in initial consultations for hematological cancer

Abstract

Objective To characterize practices in subspecialist physicians’ communication styles, and their potential effects on shared decision-making, in second-opinion consultations. Methods Theme-oriented discourse analysis of 20 second-opinion consultations with subspecialist hematologist-oncologists. Results Physicians frequently “broadcasted” information about the disease, treatment options, relevant research, and prognostic information in extended, often-uninterrupted monologues. Their communicative styles had one of two implications: conveying options without offering specific recommendations, or recommending one without incorporating patients’ goals and values into the decision. Some physicians, however, used techniques that encouraged patient participation. Conclusions Broadcasting may be a suboptimal method of conveying complex treatment information in order to support shared decision-making. Interventions could teach techniques that encourage patient participation. Practice Implications Techniques such as open-ended questions, affirmations of patients’ expressions, and pauses to check for patient understanding can mitigate the effects of broadcasting and could be used to promote shared decision-making in information-dense subspecialist consultations.

Physicians' communication styles as correlates of elderly cancer patients' satisfaction with their doctors

“…Physicians are known to be among the most important sources for cancer patients, providing them with medical and emotional support (Chhabra et al 2013). Nevertheless, relatively few studies have examined the correlations between communication styles and health outcomes among oncology patients (Ong et al 1998); literature review indicates even fewer focusing on older patients.…”

“…type of communication (Chhabra et al 2013). Previous studies identified two major communication styles: a task-focused communication style and a relationshipbuilding-focused communication style.…”

Developing a digital communication training tool on information-provision in oncology: uncovering learning needs and training preferences

“…The expressed need to learn how to tailor and structure information-giving aligns with the finding that, in a hematology setting, physicians tend to use lengthy monologues of standardized information, insufficiently tailored to patient needs, hoping to convey as much relevant information as possible in a restricted time [ 43 ]. Participants in our study seem to be conscious that this may lead to information overload, which in turn increases patients’ anxiety and hampers patients’ understanding and recall of information.…”

A clinical review of communication training for haematologists and haemato‐oncologists: a case of art versus science

“…However communication skills are reported to remain a challenge for haematologists (Alexander et al , ; Chhabra et al , ). Research has shown a tendency to ‘broadcast’ using monologues, particularly during bad news delivery in haematological cancer consultations (Chhabra et al , ). Whilst Alexander et al () described a tendency to neglect the patient's role in decision making and information preferences, there is also evidence that haematologists do not feel confident with their level of training in communication skills, with many reporting low levels of satisfaction with the degree of training they receive or the methods used before qualification (Kersun et al , ; File et al , ).…”