WHAT PATIENTS SAY, WHAT DOCTORS HEAR

Why communication between doctor and patient is the most critical element of medical care.

Ofri (New York Univ. School of Medicine) is not only a practicing clinician, but an author (What Doctors Feel: How Emotions Affect the Practice of Medicine, 2013, etc.) and editor-in-chief of the Bellevue Literary Review. Her revealing doctor-patient stories often make her seem like the doctor that every patient wishes they had, and she draws on patient accounts to illustrate the problems that can arise in communication between doctor and patient. This book, however, goes far beyond Ofri’s personal experiences with patients. She delves into the relevant research on communication, citing some ingenious experiments on listening. Studies show that the better the listener, the better the speaker, and listening is one of the hardest skills that a doctor has to master. But it can be taught, and Ofri reports that medical schools across the country are developing formal curricula to that end. However, patients, the author asserts, are the best teachers in that department, and the many stories she includes about her own struggles to communicate bear this out. In one case, she spent many visits with a patient who could not cope with multiple pills for a host of chronic conditions before discovering that all her carefully written schedules telling him when to take what were totally useless: he revealed to her that he had never learned to read. Although Ofri focuses on what doctors can do to be better communicators—e.g., focus on the patient and shut up “at least a little bit”—she offers advice to patients as well (insist on adequate time to tell your story, and prioritize what you want to talk about).

A much-needed, convincing argument that, regarding doctor-patient communication, the stakes are very high and that what patients say is all too often not what doctors hear—and vice versa.