title: Improved communication between doctors and with managers would benefit professional integrity and reduce the occupational medicine workload.
abstract: BACKGROUND
  Professional expectations for communication skills are explicit. These skills are needed for professional integrity and personal morale. Nevertheless, occupational physicians see doctors as patients for whom communication among between doctors and with their managers are the principal cause of their presenting health problems.
  
  
  OBJECTIVE
  To describe the frameworks of professionalism in medicine and the duty to care for good communication; present issues surrounding competency in communication skills; identify health problems among doctors associated with poor communication; and consider roles of economic appraisal and preventive strategies.
  
  
  METHODS
  A literature review identified key publications of professional expectations and requirements of doctors for their communication skills. Health problems among doctors associated with poor communication and presenting at least twice in a National Health Service (NHS) occupational health (OH) department during January-December 2002, were sought by manual retrieval of all doctor-patient records. The categories of communication difficulty were agreed in the focus group discussion of the presenting problems with occupational physicians.
  
  
  RESULTS
  Nine categories of communication difficulties among doctors resulting in their presentation in OH departments with health problems were identified.
  
  
  CONCLUSIONS
  Personal health problems caused by poor communication involve considerable time and potential litigation costs. Doctors need to be reminded of their responsibilities. Opportunity cost studies would help to strengthen an evidence base for the need of doctors to adhere to the professional requirements of good communication skills.
authors.affiliation: Centre for Health in Employment and the Environment, Department of Occupational Medicine, Bristol Royal Infirmary, Bristol BS2 8HW, UK. robin.philipp@ubht.swest.nhs.uk
authors.forename: R
authors.initials: R
authors.lastname: Philipp
authors.forename: P
authors.initials: P
authors.lastname: Dodwell
mesh_terms: D003142:Communication; D006801:Humans; D007400:Interprofessional Relations; D009787:Occupational Medicine / Q000458:organization & administration*; D011361:Professional Competence; D016526:Workload