Is communication a skill? Communication behaviors and being-in-relation

Abstract

There are two trends in current models of the medical interview. One focusing on observable aspects (application of techniques and abilities) and the other focusing on intangibles (the physician's self-awareness, reflections, etc.) Both trends need to reunite in order to form an efficient learning model in communication which not only provides skills but also favors constructive behaviors arrived at through true caring and a compromise with the patient. Current research and training have focused on codifying and interpreting these observable aspects of the patient- physician relationship but have not succeeded in giving coding schemes to the intangibles; nevertheless, health care providers and patients' encounters produce certain mutual interactions that could result in the modification of the decisions taken by the professionals involved. A training model similar to that of theatre actors is proposed, one that permits the practicing physician to immerse him of herself in the role of health care provider so that the professional behavior will be credible as well as morally correct. The communication process with the patient should be a process of creating relation, introducing new concepts such as informed flexibility. Data collection from patients about their experiences with health care professionals will be extremely useful in the elaboration of a new model.