The science of communication, the art of medicine

We have all heard people talk (or write) about the art and science of medicine. Sometimes we mean that there’s a certain art or craft to clinical medicine, the application of science to real people in real situations. Sometimes we are referring to the unpredictable human side of medicine, the relationships and rapport building essential to clinical and professional practice. Whether we refer to clinical judgment or communication skills, what we imply is that in science we “know” but in art we are “winging it.” Definitions of science include words such as facts, principles, laws, truth, knowledge, and systematic, while definitions of art include creative skill, imagination, appreciation, and beauty. In Roze des Ordons et al. (this issue, 2016) we read that a misplaced and inappropriate word might leave a more lasting and painful scar than a surgeon’s sloppy scalpel, or as they put it, “... unhelpful communication can cause iatrogenic suffering, with a lasting impact upon patients and families and residual uncertainty and emotional distress amongst trainees, [thus] difficult discussions should be considered as seriously as an invasive procedure.” Our interactions with patients can have lasting and profound consequences so we should not be “winging it.” We need to move the art and craft of communications to a higher level where principles and laws of human behaviour and complex interactions are systematically learned and skillfully applied.