Interview by Susan Field.
'If being ill has taught me anything about being a doctor it is the importance of seeing a patient as a person and not merely a condition or disease,' says Dr Kate Granger, founder of the #hellomynameis social media campaign to encourage healthcare professionals to introduce themselves to patients.
A registrar in elderly medicine, Kate was diagnosed with a rare sarcoma in 2011 at the age of just 29. The majority of her NHS care has been excellent but during one admission to treat a serious infection, she noticed how infrequently the doctors and nurses responsible for her care took the time to say hello.
Troubled by this experience, Kate launched #hellomynameis. While it may seem like simple good manners, the name has deeper significance. 'It's not just about an introduction. It's about being decent to another human being and ensuring the person is not 'lost' as he or she passes through the system.'
Although doctors need a single-minded approach when working through their lengthy to-do lists, the focus should be on providing compassionate care to the patient, rather than simply completing a task. 'The human connection is actually the most satisfying aspect of being doctor,' Kate reflects, 'I now know personally what a big difference it makes for patients in a frightening and unfamiliar situation.'
I have found it makes such a difference when a doctor sits down beside you and has time for a proper conversation
Dr Kate Granger
Making that connection with patients, relatives and fellow health professionals puts them at ease and is a precondition of providing effective clinical care. It enables you to communicate the risks and benefits of treatment and obtain proper consent, inspire patients' trust and work productively within a multi-disciplinary team.
Doctors who dismiss the importance of communication skills could be sabotaging their own career. Poor communication and rudeness are cited as reasons for complaint in about 30% of cases reported to the MDU.
Kate suggests the following may help improve communication with patients.
Put yourself in the patient's position
Talk to and about patients with the consideration you would want to be shown to you or a family member. 'Being in hospital can sometimes feel like a dehumanising experience so we should make every effort to see patients as more than an interesting presentation and treat each individual with dignity.' Avoid casual references to the patient as 'bed x' or 'the (name of disease)'.
Don't make assumptions
Take care to consider the impact of what you are saying to a patient. For example, telling a mother she has to stay an extra night in hospital could be highly stressful if she needs to get home for her children. 'It's important to be empathic and find out what matters to the patient,' Kate explains.
Think about body language
Non-verbal signals such as facial expressions, eye contact, gestures and posture should not be defensive or intimidating. Kate recalls one registrar who came to speak to her about a bacterial infection. 'She loomed over my hospital bed throughout, despite me asking her to sit down. Perhaps she thought that was for her benefit but it was actually for me! I felt very vulnerable and her actions emphasised the power imbalance between us. I have found it makes such a difference when a doctor sits down beside you and has time for a proper conversation.'
Be open and approachable
It's important not to be dismissive of patients' concerns. Try to ensure someone gets back to the patient in a reasonable time if you cannot answer their questions straight away.
Lead the way
A departmental culture that values good communication requires strong leadership, preferably by example. 'I think it's important to demonstrate how to communicate well,' says Kate. 'When I have to break bad news for example, I will try and get a junior doctor involved so they can gain valuable experience.'
The big conversation
The widespread support for #hellomynameis since its launch in August 2013 has been a fantastic surprise to Kate, who is now in demand to speak at local trusts and conferences. The campaign has been taken up by one or two trusts each week, and in hospitals in the USA, Canada and Australia. It has also attracted interest from CCGs, mental health trusts and nursing homes in the UK.
Communication skills for doctors
Friday 25 September 2015 - Manchester
Kate reflects: 'The NHS provides outstanding care but it is still important to reflect on how we can make things better for patients. I have always been passionate about quality improvement. I hope that #hellomynameis helps healthcare professionals make the connection with patients that is the first step to providing compassionate care.'
The MDU advises all members to reflect on this aspect of their practice, particularly if a patient interaction has not gone well. Annual appraisals, patient surveys and colleague feedback represent further valuable opportunities to evaluate your communication strengths and weaknesses.
If you need to improve your communication skills, the MDU runs regular workshops which provide practical training and advice.