Doctor-patient communication: principles and practices.

BACKGROUND In a formal needs assessment, conducted prior to the Canadian Headache Society's recent national continuing education workshop, participants expressed particular enthusiasm for enhancing their own communication skills or their teaching of those skills. OBJECTIVES Responding to both interests, this paper offers a practical conceptual framework for thinking systematically about how to improve physician-patient communication to a professional level of competence. METHODS The three-part, evidence-based framework first defines communication in medicine in terms of five underlying assumptions about communication and the learning of communication skills. It then discusses three categories of communication skills (content, process, and perceptual skills) and six goals that physicians and patients work to achieve through their communication with each other. The second part of the framework explores "first principles" of effective communication and includes a brief look at the historical context that has significantly influenced our thinking about, and practice of communication in health care. Part three of the framework describes one approach for delineating and organizing the specific skills that research supports for communicating effectively with patients - the Calgary Cambridge Guide. RESULTS It is clear from the literature that better physician communication skills improve patient satisfaction and clinical outcomes and that good communication skills can be taught and learned. CONCLUSIONS It is important that physicians learn the principles of good physician-patient communication and apply them in clinical practice. Medical education programs at all levels should include teaching of physician-patient communication.