Effective communication is crucial element of patient care

NEW YORK — Clinicians should view communication as a skill set that can help increase patient satisfaction and empower patients to become part of their own treatment, according to a speaker here at the HemOnc Today Breast Cancer Review & Perspective.

Estimates suggest most oncologists will have more than 30,000 encounters with patients and families over the course of their careers, said Walter F. Baile, MD, a professor in the department of behavioral science at The University of Texas MD Anderson Cancer Center in Houston and a HemOnc Today Editorial Board member.

“These are opportunities to provide patients with the kind of support and hope … that is important to them at a time when their self-esteem is low, they may be disconnected from friends and families, and they’re full of preoccupations,” Baile said. “There are things we can do to affect their care, and it’s clear the outcomes of effective communication are not insignificant.”

Several studies suggest effective communication can influence patients’ well-being, ensure patient retention, promote accrual to clinical trials and decrease the likelihood that patients may receive unnecessary treatment toward the end of life. It also has been shown to reduce clinician burnout and malpractice litigation, Baile said.

Even experienced clinicians struggle with some aspects of communication, such as delivering bad news or discussing end-of-life issues, Baile said.

“These skills can be taught and acquired through practice,” Baile said. “Even if you are already using some of these skills, sometimes in a busy practice we need to remind ourselves to be conscious of them and execute them in our relationships with our patients.”

Baile outlined what he called “the six Es” to help clinicians optimize communication clinical practice.

l Engage — First impressions count, and efforts to establish rapport can lead to patients feeling more hopeful about their future and more confident in their physician.

Strategies include greeting the patient warmly, maintaining eye contact, asking patients about their cancer experience, listening without interrupting, and taking a personal interest in the patient by jotting down notes about their hobbies or family.

“Taking that personal interest allows patients to feel we are treating them as human beings and not like guinea pigs or numbers, which is a common complaint,” Baile said.

Elicit — Make an effort to understand the patient’s concerns, what they already know about their disease and what they expect from their care team.

Clinicians should ask patients open-ended questions, including what they know about the current state of their treatment, what they have been told about their cancer and what they are most concerned about.

Educate — Find out how much the patient wants to know, give information in small chunks, pause for questions and verify patients’ understanding about what they have been told.

“The question, ‘Did you understand everything?’ is less meaningful than saying, ‘Tell me what you understood about what I told you,” Baile said. “A lot of times, you’ll find out patients may not have understood what you told them.”

Emotions — Clinicians should anticipate emotional reactions and plan what they will say when a patient gets upset.

They also should resist the temptation to “fix” the patient’s distress and instead should acknowledge those emotions, Baile said. Empathic responses such as “It sounds like it’s been pretty rough” or “I know this comes as a shock” can be a powerful technique.

“It lets the patient know you are tuned in to what they are experiencing,” Baile said.

Explain — Give the patient a road map so they know what to expect from their treatment.
Enlist — Ask patients and their families to be part of the treatment process.

“Having something to do overcomes helplessness,” Baile said. “Giving people a task and empowering them to participate in their own care is really helpful.”

Disclosure: Dr. Baile reports no relevant financial disclosures.