Looking back a couple of months in the archives:
>Subject: Re: radiologists compromise timely emergency care
>
>----- Original Message -----
>From: "Howarth, Paul - RCHT"
>> Junior doctor, 'I have this little old lady who has had a fall, I am not
>> sure if she has had a stroke or has a sub dural and she lives alone' etc
>> etc (long and irrelevant details follow)
>> Radiologist, 'Sounds like it can wait' etc
>> Sen A/E, 'I have a year 65 old who has had a fall, she has hit her head
>> and has a GCS of 8'
>> Radiologist, ' put me back to switch, I'll get the radiographer in to
>> warm up the scanner and I'll be there shortly'
>
>I had to laugh when I read your description Paul, how true! Sadly the long
>and irrelevant details permeate the modern SHO's notes as well!
In the case of the junior doctor, would you not describe this as a failure
of communication, not of knowledge? In the scenario described, both the
junior and senior recognised the need for a scan, but a more experienced
person was better able to communicate that need. The example refers to
doctor-doctor communication, but surely the principle extends to doctor-
patient communications also?
>> Even if we agree that both are needed, we are still faced with the
>> question of how best to train doctors so that they are good
>> communicators, and competent clinicians.
>
>Well, I'm not sure you can train people to be good communicators, they
>either are or they're not;
I don't think that I agree with you here. Possibly some people have the
potential to become good communicators and others don't, but that's not to
say that they will have the ability fully formed at age 18/23/whatever. For
instance, I've been involved in first aid training for a few years, and
it's often very noticable that a new instructor will improve as a
communicator with each course that they are involved with. Some of the best
trainers that I know openly admit that they have improved with experience,
and didn't stand up for the first time and reel off a perfect talk!
>The idea of "training" someone's attitude strikes me as bizarre; if
>they've come in to medicine in the first place then they should have the
>correct attitude from the outset. If they haven't, then your selection is
>at fault, not your training.
A potential doctor needs to have an attitude of being willing to
communicate, certainly. This attitude is not the same as having the skills
to do so. I believe that teaching them effective skills whilst they are
still students, instead of leaving them to work it out for themselves with
patients, is a good idea - provided that an effective way of doing so can
be found. To my mind it's integrating an effective system into the course
that's difficult. As was pointed out, the medical degree is so full that
anything added almost certainly has to be at the expense of something else,
and there is very little that can safely be removed.
Regards
Michael
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