There is a missing ingredient in diabetes care today.

Agroup of junior colleagues recently asked me what, after nearly 30 years of experience of caring for people with diabetes, I would consider as the single most important piece of advice to give to them as they launch into their new diabetes practice. It didn’t take me long to find an answer. ‘‘Ensure you have good communication with your diabetes patients,’’ I replied without trepidation. To start with, communication and interpersonal skills of the physician are the heart and soul of our profession as medical doctors. The primary tool we use every day at work as physicians is that of consultation and interaction with the patient. It is equivalent to how a working baker would rely on an oven or a manual blacksmith on a hammer to fulfill his or her role. The medical interview is the main conduit we use to gather information, establish diagnosis, provide therapeutic instructions, and cultivate caring relationship with the patient. Historically, physicians are not sought for their depth of knowledge or academic record but are promptly recognized for their professional skills, personal care, and wisdom. Critically, effective consultation holds the key to successful medical management. In the case of people with diabetes, the role of communication takes on special clinical relevance.