Communication for Doctors: how to improve patient care and minimize legal risks

Authors: Domhnall MacAuley 

Publication date:  04 Dec 2004

Write clearly, speak clearly, think clearly, and be nice to people. This compendium of essays, articles, lessons, speeches, and random thoughts is about communication. But it also gives us an insight into what patients think of doctors and why they don't seem to like us any more. It seems that doctors are arrogant, cannot communicate, and make little attempt to explain to patients about their illness or show concern about their welfare as people. The personal reflections of Julia Schopick on her husband's treatment stand out. She judges us from their experience of doctors managing his illness. And we fall short. Perhaps it is because she measures us against memories of her own father, a general practitioner in a previous generation. He was clearly a kindly, understanding man with time for home visiting and listening to his patients. Struggling through the rest of the book with its advice on communication, writing, lecturing, training staff, and organising a practice, the ghost of Julia's father stays with us.

David Woods, the editor and major contributor, takes us through the rudiments of writing a paper, writing for clarity, and writing for education. His contributions are straightforward sensible lessons on writing: simple words, simple sentences, and a simple message. As an experienced medical editor, he knows about the problems of communicating in writing and there are some useful lessons for the aspiring writer. He also includes a lecture that he gave to medical students. We discover that he gave it without using PowerPoint, showing that illustrations are the medium and not the message.

Medispeak is the jargon we all tend to use. His suggestion that we need to see a psycho-semantasist may be witty, but the idea that jargon can also be used to oppress or be exclusive or threatening is cruelly true. His incisive observations of the patronising use of “we” (as in “how are we today?”) or the depersonalisation of patients (as in “the emphysema in the corner bed”) should embarrass us all.

Composed of short articles gleaned mostly from other publications, the book has little cohesion and the format is difficult to enjoy. Sentimental for times past, it also made me feel a little guilty. Looking towards a bygone era where doctors seemed to have time for patients, and mourning the loss of personal care, it chides us that “physicians need to remember that, at best, medicine is not only a learned science but a personal art.”

edited by David Woods
Radcliffe Medical Press, 2004, £21.95, 152 pages ISBN 1 857 75895 1
Rating: ★★★★/5

Domhnall MacAuley general practitioner Belfast

Cite this as BMJ Careers ; doi: