Editorial

Citation

Wright, J. (2007), "Editorial", Clinical Governance: An International Journal, Vol. 12 No. 1. https://doi.org/10.1108/cgij.2007.24812aaa.001

Editorial

If there is one truism in healthcare, it is that we communicate poorly with patients. Patient complaints, medical litigation and year after painful year of patient survey feedback demonstrates this Achilles heel of health services.

We do not wake up in the morning and decide that we will spend our day in the hospital or community grunting and obfuscating. No, our flaky communication owes more to omission than commission.

There are plenty of reasons why our communication is poor. The clinic is over-running, the ward is overflowing, the patient seems to understand and is nodding vigorously to what we say yet remembers little of the content. One of the common criticisms is that doctors and nurses spend too much of their training on the technicalities rather than the human aspects of care.

A major obstacle to communication is the evidence that patients retain just a tiny proportion of what they are told in a consultation. We can improve this retention by clarity, checking and repetition, however patients will always benefit from having written information to refer to when they get home.

Two papers in this issue, by Shah and Sill and by Wills and Stephens, highlight the problems and gaps in good written communication. The weaknesses are many: bad writing, out-of-date information, inappropriate authors, lack of relevant language translation.

It is always easier to criticise than to praise and it is important to acknowledge that most attempts to develop patient leaflets are genuinely well meaning. Nationally produced leaflets can avoid some of the weaknesses, but lack the local relevance and applicability.

There are solutions for tackling poor communication. Efforts to improve standards of locally developed patient leaflets should continue and we should remind ourselves how the quality of materials has improved over the years. We should also look at more imaginative methods of communication and education – interactive DVDs, internet information, blogs and podcasts. Patients themselves may hold part of the solution with increasing evidence about the effectiveness of patients as teachers.

Better training for health care staff is also important and is being addressed in most undergraduate curricula these days. The change in emphasis from theory to communication is such that I hear medical students complaining that all they do for the first two years is practice their listening skills. Is it possible to communicate too well? Perhaps the next generation of health staff will enlighten us.

John Wright