Effective communication has always been a crucial skill for GPs to master when caring for patients and managing their practice, but the changing nature of primary care means every member of the team needs to focus on this area.
With more patients seeking treatment – average list sizes are growing and the annual number of GP consultations has increased by 70m in the last five years – the pressure on healthcare professionals to work efficiently while still providing compassionate care mounts.
At the same time, practice models are changing: smaller surgeries are closing, others are merging to create new super practices and new models are being discussed including multispecialty community providers (MCPs) which will feature a range of different healthcare professionals providing a wider range of care. Such multidisciplinary team working requires clear, effective communication, especially when care is transferred between healthcare professionals.
A third factor to consider is the rising number of patient complaints in general practice. Of nearly 89,000 written complaints (by subject) against family health services in the NHS (GP and dental) around 22% concerned communication issues or the attitude of staff, reflecting the MDU’s experience.
Given the significance of communication in general practice, the MDU believes that training should be considered for the whole practice team and that communication strengths and weaknesses should be addressed in appraisals and during the recruitment process.
And of course, it’s important that every member of the practice team understands how to effectively use and interpret verbal and non-verbal communication. Here are some principles to bear in mind:
Communication is a two-way process
Listening to patients and understanding their wishes is as important as talking to them about diagnoses and treatment. This will help ensure you are on the same wavelength as patients or carers when discussing treatment options. And if a patient is dissatisfied, listening carefully and sympathetically to their concerns can help resolve the complaint at an early stage.
Pay attention to body language
Non-verbal signals such as facial expressions, eye contact, gestures and posture should not be defensive or intimidating as the patient may already be feeling vulnerable and anxious.
Avoid medical jargon
Imagine how you feel if an accountant, car mechanic or electrician uses technical language? You probably feel quite lost. The same applies with medical jargon when talking to patients. Instead, use the phrases patients have used to describe a symptom or experience. Give them opportunities to ask questions and summarise the main points of your discussion. Patients do not always recall what has been said during consultations so in some cases, it may help to give the patient further information to take away at the end of their appointment.
Put yourself in the patient’s position
Empathy is a vital element of communication. Talk to and about patients with the consideration you would like to be shown to you or a family member eg if you are not their GP, introduce yourself and explain your role. No one should be dismissive if someone has a question and a member of the team should take responsibility for ensuring they receive a response in a reasonable time if it’s not possible to answer straight away. Even if you think the matter is not too serious, the patient might not see it that way.
Ensure you have colleagues’ attention
When delegating a task or making a referral, be clear about the information your colleague needs to know. In face-to-face interactions ensure you have their full attention (avoid corridor discussions and pick your time to avoid distractions) and check their understanding. Document instructions for patient care and treatment in the records.
Create an open culture
Encourage everyone in the practice to communicate clearly and respectfully with patients and colleagues by highlight examples of good practice and encouraging staff to raise concerns about instances of poor communication. The team as a whole can reflect on and learn from both good practice and less good practice.
Reflect on your communication successes and failures and take action
Ask for feedback on your communication skills from colleagues and look back on difficult patient or colleague interactions and think how you might have handled things differently. Attending a communications skills course or a practice training seminar from your medical defence organisation or other provider could help you to learn different techniques to build a rapport with colleagues and get your message across.