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ASCO: Communication skills training should be available to every oncologist
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A new ASCO guideline recommends communication skills training for oncologists and presents best practices for clinicians when communicating with patients and their loved ones.
These best practices include the early discussion of care goals, end-of-life preferences and costs.
“[The guideline] underscores that an important skill for each provider is to understand the patient as an individual and their families' unique needs,” Walter F. Baile, MD, co-chair of the ASCO expert panel that developed the guideline, professor of behavioral science and psychiatry, and director of the Interpersonal Communication and Relationship Enhancement program at The University of Texas MD Anderson Cancer Center, said in a press release. “[They] can help doctors form a trusting relationship with patients that is characterized by empathy, honesty, and a human connection with the patient and family.”
A multidisciplinary panel — composed of experts in medical oncology, psychiatry, nursing, hospice and palliative medicine, communication skills, health disparities and advocacy — conducted a systematic review of published literature consisting of 47 guidelines, reviews, meta-analyses and randomized controlled trials published between 2006 and Oct. 1, 2016.
Every oncologist should have access to communication skills training that uses role playing to develop skills and observation of patient interactions to provide feedback, according to the recommendations.
In addition, the guideline states that for effective communication, oncologists should:
- Clearly establish care goals with patients, and ensure that patients understand their prognosis and treatment options;
- Foster trust and confidence with patients, encourage them to discuss concerns and assist in decision-making each visit;
- Initiate conversations about patients’ end-of-life preferences early in all cases of incurable illness, as well as discuss the topic consistently based on symptoms, disease progression and patient preferences;
- Address patient concerns about cost of care directly or refer the patient and their family to a financial counselor or social worker; and
- Make patients aware of all treatment options, including palliative care for appropriate patients, such as those with incurable disease.
“Clinicians face a monumentally difficult task: to guide patients on what may be the scariest and most unpleasant journey of their lives,” Timothy Gilligan, MD, FASCO, co-chair of the ASCO expert panel, medical oncologist, and director of coaching at the Cleveland Clinic Center for Excellence in Healthcare Communication, said in the release. “We need to preserve their hope while at the same time giving them accurate information.”
The panel noted gaps exist in knowledge surrounding health care communication, in addition to the heterogeneity in the literature. More research is needed to point clinicians in the right direction for what practices they can undertake.
“We need a stronger evidence base to enhance our understanding of what to recommend when we try to persuade health care leaders to invest the resources necessary to achieve behavior change related to health care communication,” the authors wrote. – by Melinda Stevens
Disclosures: Baile reports honoraria from Eli Lilly, Empathetics and MDVIP. Gilligan reports travel expenses and accommodations from WellPoint. Please see the full guidelines for a list of all other authors’ relevant financial disclosures.
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