Improving education on doctor-patient relationships and communication: lessons from doctors who become patients.
OBJECTIVE
Medical education faces challenges in training empathetic doctors who have good patient communication skills. The author aimed to understand insights that doctors who become patients may gain concerning ways to improve doctor-patient relationships and communication in order to improve medical education.


METHODS
From 1999 to 2002, based in New York, the author conducted two in-depth, semistructured, two-hour interviews with each of 50 doctors who had serious illnesses concerning their overlapping experiences of being health care workers and becoming patients. Interviews examined their views about these issues and how their perspectives changed as a result of patienthood.


RESULTS
These doctor-patients questioned whether and to what degree empathy could be taught, but nonetheless provided several techniques for improving communication with patients related to process and content of care. Processes included charting at the bedside rather than at the nursing station, acknowledging having kept patients waiting, and increasing awareness of nonverbal aspects of care. Content issues included communicating directly about taboo topics and being more sensitive in discussing "bad news," adherence, and nonmedical concerns.


CONCLUSIONS
Doctors reported increased sensitivity to patients' experiences and empathy in doctor-patient communication. These findings can help in teaching doctors to see more clearly that their specific point of view differs from that of patients, and can be limiting. This study also sheds light on the wide separation between intellectual and experiential learning, which needs to be addressed further in medical education and research.
Klitzman
Robert
R
Columbia University, New York, New York, USA. rlk2@columbia.edu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D004501:Education, Medical; D004645:Empathy; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D033262:Narration; D009519:New York City; D010815:Physician Impairment; D010817:Physician-Patient Relations; D011787:Quality of Health Care; D012803:Sick Role