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Lupus: Communication Matters


Communication Matters
A Sometimes Overlooked Aspect of Patient Care
By A. G. Moore 9/7/2013

The Letter “C” in ASL or LSQ  (Sign Language)
From Wikimedia Commons, Public Domain

When we go to a doctor it’s often because illness has struck; this may not be a time when our communication skills are their sharpest. Does the deficit in communication have consequences? This is an issue that has been the focus of much research. The results of the research are interesting: there is a demonstrable correlation between the quality of patient/doctor communication and treatment outcome.

In 2003, the journal Arthritis Care and Research published an article which highlighted the importance of doctor/patient interaction. The article, Participatory Patient–Physician Communication and Morbidity in Patients with Systemic Lupus Erythematosus discussed a study that looked at communication between systemic lupus patients and their doctors. All of the participants agreed to be taped during their medical exams. The behavior of both doctors and patients was scored for communication effectiveness based on how much interaction occurred in meetings and how much of the interaction was initiated by patients. The findings were surprising: not only did patient satisfaction improve when communication quality was good, but treatment outcomes were also better. Those lupus patients who scored highest, who were most actively engaged during medical exams, were also patients who were less likely to experience long-term organ damage.

I think something we need to keep in mind as we process information like this is that the study does not necessarily prove a causal relationship between increased patient interaction and better outcome. Other factors may be at play. For example, people with less cognitive impairment may interact more successfully with their doctors. Thus, those who got higher communication scores may also be those who were healthier and better able to cooperate in their care. It’s hard to pinpoint cause and effect. However, other research, not restricted to lupus patients, seems to back up the conclusions reached in the Arthritis Care and Research article.

In 1995, the Journal of the Canadian Medical Association published an article entitled. Effective Physician-Patient Communication and Health Outcomes: A Review , This article described a meta analysis that was done of the Medline data base; the analysts were searching for studies that looked at doctor/patient communication. 21 studies were discovered; these yielded pretty consistent results: “Most of the studies” the Canadian research article reports, “…demonstrated a correlation between effective physician-patient communication and improved patient health outcomes”.

What we as patients should probably take away from the research is this: it’s important to consider, when we go to a doctor, whether or not we are effectively communicating. This is an essential aspect of our treatment protocol–fortunately, it’s also one over which we may have some control.

For one thing, if we cannot communicate with our doctor, perhaps we should find someone else to treat us. If this is not feasible–or advisable–then there are other, less dramatic measures we might take. A suggestion offered by many respected advocacy organizations is that we take someone with us when we go to a medical consult. The Lupus FoundationAARP  and the Illinois Disability and Health Program  all cite this as one way to enhance doctor/patient communication.

If there isn’t someone you can take with you, or if you feel uncomfortable doing this (I know I do), there are other techniques you can use to help insure you get everything you can out of a consultation with your doctor. One simple thing, which I find is often received well by doctors, is to summarize your medical history and type it out in advance.  Also type a list of questions.  And bring a pen, so that, during a visit, you can note important information as it is given to you. I have also read on a few sites that it might be a good idea to bring a tape recorder so you can record what the doctor says. I’m not sure I’d ask a doctor to do this, but it certainly would clear up confusion that might exist about what transpired.

It’s a given that when illness strikes we are confronted with unusual challenges; some of these may seem overwhelming.  When we go to a doctor it’s to help us deal with serious issues. Research shows that good collaboration–doctors and patients communicating with each other–is the best way to resolve those issues. After all, the most effective teams are those that work well together



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