Week 8: Communication is Key

Sometimes what you say is less important than how you say it; how you communicate information and transform it into knowledge.  Communication is critical in almost any discipline and medicine is no exception.  The communication between doctors and patients, communication between doctors and nurses or other healthcare professionals, even communication between one group of doctors and other doctors has the potential to be a determining factor in the success of a treatment or therapy.  Although I observed these types of communication throughout my time at New York Presbyterian Hospital, certain occurrences this past week specifically reminded me of the importance of communication in medicine.

My observations started with physician-patient communication during morning rounds.  It was the patient’s wife in particular who asked innumerable questions of the attending physician, holding him in the room, long past the few minutes usually spent with each patient on rounds.  The patient was experiencing a number of complex medical issues, and Interventional Radiology had been called in to perform only one procedure that amounted to a small part of the overall treatment plan.  However, as the attending physician explained the upcoming steps and options following the procedure that IR had already completed, it became clear that the patient and his wife were desperate to know what would happen in the future, how the disease would be treated, and what it meant for the patient’s life.  Unfortunately, the patient’s main team of physicians seemed to have not properly explained what the treatment plan would be, nor explained all the reasons behind the choices that had been made so far.  In this case it was not question of not the patient not understanding the information (the wife in particular was very well informed and asked intelligent questions) but rather the other physicians apparently had not taken the time to communicate with their patient or his family.

Communication with patients is not limited to before and after procedures.  While in many surgeries, the patient is anesthetized and completely unconscious, in IR the physicians often chose to perform the procedure with nothing but sedative and a local anesthetic, keeping the patient in a semi-awake (“twilight sleep”) status.  This practice reduces some of the risks associated with anesthesia, but it means that the patient is constantly aware and the physician must take care to communicate with the patient throughout the procedure, letting them know what is happening.  One patient I witnessed became upset upon feeling a constriction around her arm.  The constriction turned out to be a blood pressure cuff, a harmless and routine part of monitoring patient health during the procedure.  However, when a patient is nearly helpless, lying on the operating table, even something simple can be scary.  The experience emphasized the need to maintain a dialogue with the patient throughout the procedure. Even for simple things, if it is something the patient can feel, it is important that the patient be forewarned.

As I worked to complete my summer research project, I discovered an entirely different type of medical communication: recording results of medical studies in a way that could not only be understood by the other members of the research team, but by any physician in the same field.  In my own research I have frequently needed to express my work in a format that would be understandable to together researchers, even those outside my specific field.  The same concept applies to the medical-related research I have worked on this summer, but the audience is different (doctors instead of scientists and engineers).  In order to communicate my work effectively, I need to keep the experience and background of the audience in mind to ensure that my efforts to discover new medical information are able to advance medical knowledge in a way that would hopefully help patients.