Saturday, June 16, 2012

Healthcare Communications in the Age of Inattention - CCC VitalSigns

The Irish physician Sir Dominic John Corrigan, famous for his early observations in heart disease, once said: ?The trouble with many doctors is not that they do not know enough, but that they do not see enough.?

That was 1853, about a century or so before TV, computers, the Internet, email, digital media and the eight-minute patient visit.

What would Corrigan say today?

As the Wall Street Journal noted in an article last week, we live in ?the age of inattention.? We text as we walk, email as we sit in meetings, tweet during dinner conversations. In the process, we miss nearly everything. According to a four-year-old study commissioned by Lloyds Insurance, our average attention span dropped 50% over a decade, from 12 minutes to just five.

We?re overwhelmed by information, surrounded by noise and pressed for time ? and this applies both to physicians and patients. One result of all the digital distraction is a severe decline in our powers of observation. It seems the more we view, the less we actually see.

To address the problem, Yale University?s medical school and about 20 other medical schools across the country have adopted mandatory training to teach first-year medical students better observational skills. (A number of medical societies also offer such training.) The course uses art ? in the case of Yale, British paintings ? to teach analytical observational skills rather than just the rote memorization and pattern recognition that are the central feature of medical school education. The observational skills taught through viewing art can be transferred to observing patients in the examining room.

Such observation, visual and aural, is a pillar of diagnostics. The medical axiom goes, ?If you listen, the patient will tell you the diagnosis.? So programs that teach doctors ? both students and practicing ? better observational skills and techniques for listening are of paramount importance in quality care. But there is an equally important role for patients.

As healthcare communications professionals, what can we do to help patients improve their own observational skills in an age of inattention? What can we do to help patients organize these observations and communicate them specifically and effectively?

One thing we can do is give them the language they need to describe what they feel and tools for enhancing the physician-patient conversation. We can provide a preliminary list of questions to ask that they can build upon and teach health literacy in a wide variety of ways. For example, an upcoming issue of a magazine we help create for the Crohn?s disease community is dedicated to helping Crohn?s patients better communicate their symptoms. Like many with chronic diseases, Crohn?s patients sometimes wait to be asked about changes in their health. The magazine provides guidance in how to volunteer information before the doctor inquires and how to think through questions they want to ask once the visit begins.

Since the time of Hippocrates, physicians have been told to listen, because in sharing their symptoms and histories, patients are the best source of information for making an accurate diagnosis. Although physicians have come to rely more and more on diagnostic testing and technology, communications between physician and patient remain at the core of diagnosis and treatment.

As our attention spans dwindle and the time physicians spend with patients declines, our role as healthcare communicators has never been more important.

How do you think healthcare communicators can bridge the gap in this age of inattention?

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