Effective Communication Skills
Dr. Faisal Al Hadad
Consultant of Family Medicine
Communication: a process of production and submission of
knowledge/symbols, which are received and interpreted by the
70% of the patients can be diagnosed by only communication
Patient satisfaction increases when he/she can have a good
communication with doctor.
Doctors who are good communicators are less suited by their
77% of patients don’t express their reason of
attendance during consultation
50% of patients leaving doctors office with
insufficient information on their illness.
50% of patients leaving doctors office don’t know
how to use their medication
to elicit as accurately as possible, in the
limited time available, the information needed
to make a diagnosis and plan treatment
the patient adequate opportunity to
express his feelings
The doctor should ask questions in clear, unambiguous language
suitable to the patient's age, education, and cultural background.
The pattern of questions should follow some logical grouping and
sequence. If the doctor does have an after-thought, he should
Topics that the patient may feel sensitive about should usually be
introduced in the latter part of an interview when confidence and
rapport have been established.
Causes of reticence
The presence of a third party
Sometimes the fact that the doctor is also the family doctor may
inhibit an adolescent from speaking freely.
The patient may fear that revealing his complaints will lead to
the realization of his worst fears.
A reluctance to take up the doctor's time with concerns that the
patient may feel are undeserving of his time and attention.
Embarrassment or shame about the nature of the complaint
Ways of facilitating communication
Non-verbal (body) language
appropriate use of silences
Discarding pen and notes
Leaning forward towards the patient
Active (attentive) listening
Appropriate use of touch
Empathy: the capacity to sense what it is like to be the
A variety of simple short responses from the doctor will encourage the
patient to continue speaking.
e.g. “Yes, I see”, “Go on”, “I understand”.
Reflecting: encouraging the patient to continue speaking by reflecting
back to him a phrase, idea, or significant word from what the patient has
Patient: "The period pain are not too bad, but the headaches I get before
the periods starts to make me desperately miserable for three or four
days every month"
Doctor: "You feel desperately at that time?
Patient: "Yes, to be honest I do. Recently there have been several times
when I have thought of doing away with myself, because at that time it felt
as if there was nothing to live for"
Clarifying: make clear to the patient what he is trying to put into
e.g “Are you trying to tell me that you are really afraid this is
something very serious? Is that what you feel?
Summarizing: summarizing all or part of the patient's accounts
e.g "So if we could just go over the main points of what you
have told me so far. Your periods were perfectly normal and
regular until five months ago. Then you missed two periods
completely and then bled heavily for three weeks. Since that
time there has been some scanty loss most days, but no pain
at any time. Is that correct?
Appropriate use of silences
Silence can occur when the patient runs out of words or is unsure
about expressing his feelings:
- Resist the temptation to disarm the silence with a new question
on a new topic.
- Let the silence remain unbroken for a little time while
continuing to look at the patient with a facial expression of
unhurried interest and concern.
- Signal “Go on” either verbally or non-verbally.
Facilitating the open expression of
If the patient shows evidence of suppressed emotions the doctor
- resist the temptation to jump in with distracting questions or a
less motive topic.
- not exhort the patient to cheer up or to "take a grip on
- remains silent for a moment and continue to look towards the
patient with an expression of concern
Mirroring: letting the patient see what his non-verbal expression
show (like holding a mirror)
“You were almost biting your teeth when you mentioned your
Confrontation: a more blunt and direct way of saying what the
.patient appears to be going through
” e.g. “You were very angry when you mentioned your son