What doctors (and patients) can learn from air traffic controllers: What's that you say

March 7, 2011

A review of 35 years of scientific medical studies confirms that the social and emotional context of the doctor–patient relationship have yet to be incorporated into the equation when it comes to health care.

In spite of its strong endorsement over a decade ago by the influential Institute of Medicine report, "Crossing the Quality Chasm: A New Health System for the 21st Century," which highlighted the benefits of care that is respectful of and responsive to patients' needs, values and concerns, patient-centered medicine has not become part of the mainstream.

A review of the medical literature from 1975 to April 2010 found that less than one percent of the 327,219 randomized controlled studies published in peer-reviewed journals over the past 35 years included patient-centered care trials. "Behaviorally–Defined Patient-Centered Communication – A Narrative Review" appears in the February 2011 issue of the Journal of General Internal Medicine

"We are only at the water's edge in terms of availability of patient-centered care studies because they aren't being done. We need to encourage researchers to implement clinical trials that evaluate care that focuses on communication between physician and patient. Ultimately, we need processes that have been tested and proven," said Richard M. Frankel, Ph.D., Regenstrief Institute investigator, professor of medicine at the IU School of Medicine, and a senior scientist in the Veterans Affairs Center of Excellence for Implementing Evidence-Based Practice at the Richard L. Roudebush VA Medical Center. He is the senior author of the JGIM paper.

Dr. Frankel uses an analogy from aviation where safety is given the highest priority. "When the air traffic controller gives an instruction to the pilot, the pilot's response must be phrased to indicate understanding of the air traffic controller's message. We don't have that in medicine. The doctor speaks to the patient and generally does not solicit a response that clearly indicates the patient understood what the doctor wished to convey."

As with the cockpit and control tower exchange, the exchange at the hospital bedside or in the doctor's office requires communication of complex information in stressful circumstances. In both aviation and medicine, good communication is critical to safety.

"What we have found repeatedly is that medical care succeeds when there are stable and enduring relationships," said Dr. Frankel. "Successful outcomes lie not simply in the mechanics of medical care, but in the social and emotional context of the doctor-patient relationship."

Explore further: 'You're not a victim of domestic violence, are you?'

Related Stories

'You're not a victim of domestic violence, are you?'

November 5, 2007

Doctors who ask the right questions in the right way can successfully encourage abused women to reveal that they are victims of domestic violence, even in a hectic emergency department, a team of researchers from the United ...

Doctor who? Are patients making clinical decisions?

February 11, 2008

Doctors are adjusting their bedside manner as better informed patients make ever-increasing demands and expect to be listened to, and fully involved, in clinical decisions that directly affect their care.

End of life physician-patient communication

July 22, 2008

Although a growing body of research supports a link between effective communication and patient, family and physician satisfaction, doctors, including oncologists and other specialists who frequently care for terminal patients, ...

Don't ask, don't tell doesn't work in prenatal care

September 30, 2008

While obstetrical care providers are doing a good job working with their patients on smoking cessation, they are not doing as well on abuse of other substances that can harm a woman's unborn baby. A new study appearing in ...

The total package: A skillful, compassionate doctor

January 22, 2009

Patients and their families want physicians who are gifted in diagnosis and treatment and who are caring individuals with the interpersonal skills needed to communicate complex information in stressful circumstances.

Patient-centered Care Can Lower Risk of Death in Heart Attack

July 23, 2010

In 2001, the Institutes of Medicine named patient-centered health care — based on patient preferences and needs — as a major and necessary change in America’s health care system to improve the quality of medical care. ...

Recommended for you

Machine Translates Thoughts into Speech in Real Time

December 21, 2009

(PhysOrg.com) -- By implanting an electrode into the brain of a person with locked-in syndrome, scientists have demonstrated how to wirelessly transmit neural signals to a speech synthesizer. The "thought-to-speech" process ...

Quantum Theory May Explain Wishful Thinking

April 14, 2009

(PhysOrg.com) -- Humans don’t always make the most rational decisions. As studies have shown, even when logic and reasoning point in one direction, sometimes we chose the opposite route, motivated by personal bias or simply ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.