The patient-practitioner relationship: interpersonal skills

Psychology A2 · Health Psychology. The idea in plain words, the rules to remember, the mistake to avoid and a worked example, written and checked by Mega Lecture.

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The idea

Patients judge a practitioner by more than words. Non-verbal communication includes clothing, posture, eye contact and tone. Clothing signals professional status and affects trust. McKinstry and Wang (1991) showed patients in Scottish general practices photographs of doctors in different styles of dress. Most patients preferred formal dress, and older patients preferred it most.

Verbal communication fails when doctors use medical terms that patients do not understand. McKinlay (1975) tested how well women in a Scottish maternity ward understood terms used by their doctors. Some terms were poorly understood. The doctors expected even less understanding than the women showed, yet they still used the terms.

Poor understanding leads to poor recall and patients not following advice.

Rules to remember

Non-verbal communication: messages sent without words, such as clothing, gesture, eye contact and tone of voice.
McKinstry and Wang (1991): photographs of doctors and a questionnaire; formal dress was preferred, especially by older patients.
McKinlay (1975): some medical terms were not understood; doctors underestimated the women’s understanding but used the terms anyway.
Clear communication: plain words, short statements, key advice first, repeat it and check understanding.
Photographs of the same doctor in different clothes control other variables, but they are less true to life.
Questionnaires give quick quantitative data from many patients; this is a nomothetic approach.

Common mistake

Students write that clothing changes the quality of medical care. It changes the patient’s impression and confidence, not the doctor’s skill.

Worked example

A doctor tells a patient she has had a “negative” test result. She goes home very worried. Which problem of verbal communication explains this?

In medicine, a negative result means the condition was not found, which is good news.
In everyday speech, negative means bad.
The patient used the everyday meaning because the term was not explained.

Answer: Misunderstanding of medical terminology; the doctor should use plain words and check understanding.

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