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ISBN: 9780198527749

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Difficult Conversations In Medicine

Elisabeth Macdonald

In all branches of medicine, effective communication between health care professionals and patients, families and carers is essential to ensure first-class treatment. Increasing public awareness of health issues and the ready availability of health information have lead the public to be more widely informed about common conditions and the treatments available. Patients therefore attend a medical consultation better informed so the need for improved communication skills is even greater. This book aims to demystify the 'doctor-patient' relationship in order that patients and potential patients can more easily understand the information which doctors are seeking to convey as well as gaining some insight into the difficulties of communication from a doctor's perspective.

Some conversations require specialised skills. Talking to people with difficult personalities and poor social skills can be challenging. Strong emotions of anger, frustration or distress need sensitive handling and particular age groups call on styles of address appropriate to their particular needs. Using the expertise of experienced doctors from many specialties this book covers not only the theory behind good communication skills but also gives a wealth of practical advice.

The book covers ethical and legal issues, planning difficult conversations, the patient's and doctor's perspectives, issues surrounding special groups such as children and the elderly, and conversations with patients from different cultural backgrounds. Outlines of possible clinical cases posing specific problems are included with guidance on how to handle them.


Readership: Undergraduate medical students, junior doctors and other health professionals in training

Introduction, Theo Schofield 1. An introduction to basics, Liza Macdonald 2. Fundamentals of good communication, Liza Macdonald 3. The ethics of communication, Michael Parker 4. Overall plan of management of difficult conversations, Liza Macdonald 5. The patient's perspective, Liza Macdonald 6. The doctor's perspective, Liza Macdonald 7. Dealing with strong emotions and difficult personalities, Peter Maguire 8. Difficult conversations with children and parents, Melinda Edwards 9. Special adult groups, Liza Macdonald 10. Difficult practical circumstances, Liza Macdonald 11. Communication in a multiprofessional setting, Cathy Heaven 12. Communication in a multicultural society, Liza Macdonald 13. Apologies in clinical medicine, Carmel O'Donovan 14. Legal constraints and guidelines to good practice, Liz Martinez 15. Maintaining a balance, Peter Maguire, Carolyn Pitceathly, Catherine Hood & Liza Macdonald 16. Conclusions and future directions, Liza Macdonald Appendix I: Transcripts of useful illustrative conversations, Catherine Hood & Liza Macdonald Appendix II: A curriculum for communication in medical education, Theo Schofield
Elisabeth Macdonald