9 HISTORICAL DEFICIENCIES IN TEACHING COMMUNICATION SKILLS When I attended medical school over half a century ago there were no courses whatsoever on physician–patient communication. It is almost amusing to recall the only formal discussion that I remember from my student days. One of the senior attending physicians in the department of obstetrics and gynecology told us on rounds one morning that if the patient requests information about her disease the most useful

word to use is “condition”. “Just tell her”, he said, “that she has a ‘uterine condition’, without Inhibitors,research,lifescience,medical any further elaboration. That will satisfy 95% of the patients, and you will not have to supply any further details about her

diagnosis.” That was the sum of the teaching of Inhibitors,research,lifescience,medical communication skills that was provided to me and my Ruxolitinib manufacturer fellow students during 4 years of medical school! Nor were these defects remedied in any significant way during my residency training at outstanding academic institutions. But the lack of attention to communication skills has come to haunt the medical profession. Perhaps the research published Inhibitors,research,lifescience,medical in the late 1960s by Barbara Korsch and her colleagues,10–11 highlighting the gaps in doctor–patient communication, provided the scientific impetus for further research and then remediation of the situation. Recent articles continue to report serious shortcomings in communication skills.12 Even with outstanding formal teaching unless there is reinforcement during the clinical

years and good role models the gains of the teaching may deteriorate significantly under the stresses Inhibitors,research,lifescience,medical of work and the “hidden curriculum”. “PATHOPHYSIOLOGY” OF DEFICIENCIES IN PHYSICIAN–PATIENT COMMUNICATION One should examine first the “pathophysiology” of the problem in physician–patient Inhibitors,research,lifescience,medical communication in order to prescribe appropriate solutions. PRIORITIES OF TECHNOLOGY The advent of technological and sophisticated methods of diagnosis and treatment of disease has relegated the communicative interaction with the patient to a lower priority. A leading daily newspaper pointed out the following: “The CT and MRI scans, the 17-DMAG (Alvespimycin) HCl lasers and the laparoscopics, the chemo cocktails and DNA codes – all the advances that make modern medicine so effective (and expensive) have isolated physicians from the patient as a person. In the process, the ancient therapeutic art of listening is being ignored, much to the dismay of many physicians who recognize the limits of technology.”13 Going back to the invention of Laennec, who introduced the stethoscope to replace the direct placement of the physician’s ear on the patient’s chest, we have progressively decreased the direct contact of the physician with the patient.