Communication skills and anesthesiologists

Effective communication between doctor and patient improves health outcome or patient's satisfaction, and reduces error, misunderstandings, distress, and negligence claims.[1]

Anesthesiologists are expected to communicate effectively with peers, patients, their families, and colleagues from medical fraternity. They have to take a focused history and perform a targeted examination during preanesthetic visits, both in elective and emergency scenarios, explain the risks and complications associated with the procedures to patients and relatives, and obtain consent for the same. They perform invasive procedures, during which communication to facilitate relaxation and comfort becomes important. Good communication skills of anesthesiologists are also warranted during anesthesia administration, surgical procedures, emergence from anesthetics, and handing over in the recovery room, intensive care units in pain clinics.

It was believed that communication skills are something that one is born with, but actually it is a skill that can be taught and improved upon.[2]

Communication with patients or colleagues can be of two types namely conscious and subconscious. Conscious communication is based on logic and reasoning, while subconscious communication is expressed in the form of metaphor, symbolism, and imagery. Anesthesiologists can increase rapport with the patients by providing sense of control in decision making, offering choices, reflective listening and observing, acceptance of different realities (like patient's beliefs or emotions, even if strange), utilization (patient's presenting problems and concerns are reframed as solutions), and suggestion (direct, indirect, positive, negative, and linked). On the contrary, rapport decreases if the anesthesiologist is rude and blunt in his/her presentation, calls them by wrong name, appears not to pay attention, promotes or talks negatively about something/somebody, and shows unnecessary sympathy.

Good communication between anesthesiologists, surgeons, paramedical staffs, and peers is known to reduce adverse events.[3] Situational awareness, problem identification, decision making, workload distribution, time management, and conflict resolution are some of the measures taken for the effective teamwork.[4]

A survey was conducted amongst the delegates attending an international neuroanesthesia conference.[5] Following important observations were made:

• 95% of the participants felt that good verbal communication leads to better patient outcome;

• 98% agreed communication between surgeons and anesthesiologists is important;

• 85% said failure of communication causes stress;

• 89% had no formal training to improve their communication skills during graduation/post graduation program;

• 82% felt that communication skills training should be made mandatory in the curriculum.

Although, most of the anesthesia text books do not include communication skills as their chapters, anesthesia residency review committees in different countries[6,7] now demand documentation of training in communication skills. So, time has come when all anesthesiologists should not consider themselves to be endowed with good or bad communication skills, but actively pursue the efforts to improve upon it to provide better support to their patients and create a harmonious work environment.