Is there still a need for face to face discussions in a world of technology?
My work setting is an academic medical center. Communication occurs constantly during my work day with many different parties involved. There are the typical student learners including medical students, allied health students, residents, fellows, and faculty. Learners can gain information by many routes, but having an experienced teacher to guide the acquisition of knowledge and to mentor the learner in non-pedagogical roles may be more important.
Texting is all the rage with people walking while texting and driving while texting a common occurrence, which can lead to morbidity and mortality. There is the classic hand written communication although the formal 'cursive' is being phased out as a subject that is taught. Electronic media is king. The tweet, text, email, twitter, and facebook page are all popular with billions of dollars being consumed. But, face to face communication is still the ultimate way to communicate. Electronic communication is efficient, but often the reader inserts their own context and emotion into the message. Face to face communication is important as a majority of communication is non-verbal and it conveys most of our message. Body language, facial expression and eye contact are all very important parts of the message.
Patients and their caretakers are very important groups that we must educate. The evidence base indicates that proper education can improve outcomes like compliance with medications, appointment follow ups and decrease the readmission rate to the hospital. From a patient and family perspective, they want to know the what, why, when, and how of the disease that is being treated. Most importantly, they want to know the prognosis, which is the ultimate question and the reason for information gathering. Can they return to home? Will they be able to work or go to school? Our clinicians need to have optimal communication skills to improve quality of care, maximize satisfaction and practice in an efficient manner. To minimize the chance of harm to our patients, communication is paramount. Hand-offs of clinical care is the time when miscommunication is most likely to occur.
There is now pressure from CMS (Centers for Medicare and Medicaid) to fiscally reward patient satisfaction and 'better' outcomes. There is also a disincentive if the outcomes are not achieved. The fiscal emphasis will likely increase over time. These are some of the challenges, but there are also opportunities with change.
Remember, when you communicate, you are sending an important message by what and how you do it.
*And, if you don't communicate, you are also sending a message. It's amazing what you can accomplish by communicating to and listening to others.
Daniel P. Moore, MD
Professor & Department Chairman
Medical Director of Regional Rehabilitation Center
Medical Director of Wound and Hyperbaric Center
Board Certified, American Board of Physical Medicine & Rehabilitation
Board Certified, Pain Medicine
Board Certified, Pediatric Rehabilitation
American Board of Neuromuscular and Electrodiagnostic Medicine