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Department of Medicine

Department of Medicine

  Division of General Internal Medicine

Institute for Doctor-Patient Communication

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The University of Pittsburgh School of Medicine recently established the Institute for Doctor-Patient Communication as part of an ongoing effort to promote the development of effective communication skills between physicians and their patients and to serve as a focal point for education and research on one of the key issues in contemporary medical education.

"The fundamental relationship between a doctor and his or her patients is really the soul of the medical profession. We take very seriously the mission to train our doctors to build and maintain this relationship, including the development of good and effective communication skills," said Arthur S. Levine, MD, senior vice chancellor for the health sciences and dean of the School of Medicine. "The establishment of this institute is just one more way in which we hope to reinforce this effort."

The director of the new institute is Robert M. Arnold, MD, Leo H. Criep Chair in Patient Care, professor of medicine, and chief of the Section of Palliative Care and Medical Ethics at the School of Medicine.

"This institute will serve as an umbrella under which the medical school can coordinate both its teaching and research efforts in doctor-patient communication," Dr. Arnold said. Bruce S. Ling, MD, MPH, will serve as co-director of research for the institute, and Laurel Milberg, PhD, will be co-director for education.

"The development of this institute is really an outgrowth of the establishment of the Criep Chair in Patient Care in 2000 and the realization that a wide range of people and programs are needed to be involved in improving relationships between doctors and their patients," Dr. Arnold said. "Despite all the scientific advances in medicine over the last century, sitting down and talking to patients is still the most common and one of the most effective things that doctors do." Dr. Criep, for whom the chair is named, was a 1920 graduate of the University of Pittsburgh School of Medicine and held a strong belief in the importance of doctors maintaining compassion and understanding in their dealings with patients.

Initially, the focus of the institute's education goals will include identifying critical communication skills that all medical students should have developed by the time they graduate and then working to ensure that those skills are adequately taught and evaluated as part of the curriculum, Dr. Arnold said. "In the future, we plan on expanding our efforts to look at how other health care professionals are trained to communicate with patients. For instance, it's essential that medical students, in their interaction with patients, learn not only to ask the right questions but to ask them in a therapeutic manner, because these skills will carry them through their entire career," he said. "The particular diagnostic questions they ask may change as advances are made in science and medicine, but the process of communication will stay fundamentally the same, and that's what we hope to emphasize."

On the research side, one of the early goals of the institute will be to provide support for a cadre of researchers to study doctor-patient communication. This will involve regular meetings to discuss research ideas and to decide on joint projects.

"Nationally, there is relatively little research being done on doctor-patient communication and how we can evaluate what physicians are doing when they talk to patients," Dr. Arnold said. "There has been lots of research on patient satisfaction, but very few people look under the hood, so to speak, and say, 'What is the relationship between what the doctors say and what patients hear?' Moreover, we need to move beyond satisfaction to look at issues regarding the relationship between communication and patient behaviors and outcomes. We want this new institute to become a hub for training people to do this kind of research."

Nevertheless, effective communication skills are typically one of the most important factors that patients use in selecting a physician and gauging their ongoing satisfaction with that physician. "As the health care industry grapples with changes that have put increasing pressure on the amount of time that doctors and patients typically spend together, and as consumers become more and more knowledgeable about health care issues, thanks in large part to the media and the Internet, developing good relationships between doctors and their patients has never been more critical than it is now," Dr. Levine said. "As the only medical school in western Pennsylvania and as the University of Pittsburgh Medical Center's partner in the largest health care system in this region, it is not only our responsibility to make this issue of improved doctor-patient communication a priority, but it is also the right thing to do."