Health Professional Communication Competences and Patient Evaluation in the Therapeutic Encounter: It Takes Two to Tango

Introduction

We start the presentation of our chapter with the question made by Dimatteo and Taranta (1979): “If a physician is technically competent, does it matter if he or she is empathic, or caring, or kind in the process?” (p. 540). The authors answer, referring that the medical, public health, and social-psychological literature show strong indications of the importance of complementing the technical knowledge and expertise of physicians with effective interpersonal treatment (p. 540).

In fact, effective communication between patients and their physicians is “one of the cornerstones of high-quality medical care” (Monti et al., 2020; Osch, Dulmen, Vliet & Bensing, 2017, p. 1482; Stewart et al., 2000) and there is a significative evidence that it has positive effects, contributing to diagnostic, therapeutic outcomes, patient and provider satisfaction and efficient use of resources (Tiwary, Rimal, Paudyal, Sigdel & Basnyat, 2019; Williams, Weinman & Dale, 1998). Doctor-patient communication is a pivotal component of clinical practice communication and is a complex interaction that requires an understanding of each party’s emotional state (Kee, Khoo & Koh, 2018).

In spite of communicating with patients is arguably the most common and important activity in medical practice, this activity receives relatively little attention in graduate medical education (Henry, Holmboe & Frankel, 2019). But, promissorily, it is noted a renewed interest in communication skills in graduate medical education (Kee et al., 2018). The pertinence of communication competences is undeniable due to if these concrete competences “are practiced adequately, the quality of healthcare communicate is increased and, as a result, risk of avoidance of preventable adverse events (pAEs)” (Hannawa, Wendt & Day, 2017; Lippke et al., 2019, p. 3). The problem of pAEs is worrying because studies have revealed that, in clinical settings, poor communication may be responsible for up to 80% of all pEAs, which affect patient safety, that are generated by unsafe healthcare processes, rather than by the patient’s medical condition (Leonard, Graham & Bonacum, 2004).

The literature tends to highlight the “bottom line”: the positive therapeutic rapport that patients enjoy with health professionals depends on mutual expectations and on an aligned communication flow from patient to health professional and vice versa (Huntington & Kuhn, 2003, p. 158). For example, Tavakoly Sany, Behzhad, Ferns and Peyman (2020) mention that communication skills training for physicians improves health literacy and medical outcomes in patients with hypertension.

On the contrary, communication failures are the leading causes of inadvertent patient harm (Leonard et al. 2004, p. i86). One possible reason for this event is the overestimation by doctors, nurses and other health professionals on their communication skills. For example, some studies confirm that the doctors overestimate their rapport building skills, or not pay great attention to it, and, thus, assume good knowledge and practice without real application (Albahri, Abushibs & Abushibs, 2018; Alnasser et al., 2017; Ha & Longnecker, 2010). There are studies that report that, since nurses’ communication skills are related to their own perception of professionalism, communication skills should be considered a predictor of success (Kim & Sim, 2020, p. 10).