Improving Medical Communication

Physicians are not typically trained in interpersonal communications and are not rewarded based on their communication skills.

Equally important, patients are often intimidated when talking to doctors and often feel they don’t have a receptive audience, especially when doctors are rushed. What can be done about this on both sides of the challenge (patients and doctors) — including possible initiatives in areas ranging from education to technology, to possible changes in the physical workspace? How do we make this issue a priority?

Watch Live Event Recast: Event 1

Meet the Challenge Team

The Challenge Team Members are leaders in their fields and reflect multi-disciplinary, passionate and thoughtful perspectives for the Challenge they represent.
Challenge Team members participate in the discussion held by the Great Challenges community, and will be creating responses to questions submitted by the community on the discussion tab.

  - look for this icon throughout the Great Challenges discussions. It is used to identify comments posted by the Challenge Team members.

RobertArnold.jpg
Robert Arnold, MD
Director, Institute for Doctor-Patient Communication, University of Pittsburgh School of Medicine
RobertArnold.jpg

Robert M. Arnold, M.D., is a Professor in the Division of General Internal Medicine, Department of Medicine at the University of Pittsburgh and in the University of Pittsburgh Center for Bioethics and Health Law. He completed his medical school training at the University of Missouri-Kansas City and residency at Rhode Island Hospital. Subsequently he has been on the faculty at the University of Pittsburgh. In 2000, Dr. Arnold was named the first Leo H. Creip Chair of Patient Care. The chair emphasizes the importance of the doctor-patient relationship, particularly at the end of life. He is the Director of the Institute for Doctor-Patient communication and the Co-Director of the Institute to Enhance Palliative Care. He is clinically active in palliative care. 

Dr. Arnold has published on end-of-life care, hospice and palliative care, doctor-patient communication and ethics education. His current research interests are focused on educational interventions to improve communication in life-limiting illnesses and better understanding of how ethical precepts are operationalized in clinical practice. He is the Past-President of the American Society of Bioethics and Humanities as well as the American Academy of Hospice and Palliative Medicine.

I have spent most of my life in medical education focusing on teaching physicians to communicate with seriously ill patients. Doing this has convinced me that most physicians want to develop good relationships with their patients. I think people often do not understand how hard physicians’ work or how much they care for their patients.

On the other hand, I also understand how complicated the medical system is and how frustrating it is for patients and their families. I also understand that doctors can forget how foreign the medical system is or make the experience worse by speaking in an unintelligible medicalized language.

Robert Arnold, MD
Director, Institute for Doctor-Patient Communication, University of Pittsburgh School of Medicine
Selma_Caal.jpg
Selma Caal, MD
Research Scientist, Child Trends Lead Author
Selma_Caal.jpg

Selma Caal, Ph.D. is an applied developmental psychologist and a Research Scientist at Child Trends. Her current research focuses on qualitative research methodology examining the reproductive health behaviors of young adults, particularly of racial/ethnic minorities. She is the lead researcher for a qualitative study looking at the decision-making process to prevent unintended pregnancies and STD contraction among African-American couples. She is also conducting two qualitative studies, one of which focuses on identifying barriers and facilitators to accessing family planning services among Hispanics. The second study examines the use of Natural Family Planning methods and fertility awareness among black and Hispanic women. Dr. Caal also has experience in program evaluation, examining impact and process data. As part of her work, she is an expert in translating study findings into recommendations for stakeholders for program implementation and service delivery improvement. In addition to her research experience, Dr. Caal has substantive experience working with diverse individuals, particularly Latino and African-American, in both research and practice. 

Working with underrepresented populations in research and practice, I have witnessed that some individuals do not receive health care services because they often face many barriers. Some barriers are practical, such as lack of health insurance, lack of transportation, and lack of childcare. Other barriers might arise due to the cultural mismatch the patients encounter within the health care system. While providers may want to diminish the practical barriers patients face, health care organizations might have to commit to large financial investment to do this. However, efforts to minimize cultural barriers between provider and patient do not have to involve large financial investments.

Selma Caal, MD
Research Scientist, Child Trends Lead Author
JohnCox.jpg
John Cox
Co-Founder, President and Chief Executive Officer, Visible Health, Inc.
JohnCox.jpg

In his role as President and CEO of Visible Health, John is primarily responsible for establishing vision, developing market and business development strategy, and managing marketing, business development, and sales functions. He is an enthusiastic healthcare product strategist, building on years of experience as a product manager and product strategist in healthcare, internet, and enterprise software markets. 

Prior to the founding of Visible Health, John was the President and CEO of Escalation Point, a healthcare product strategy, design and development consultancy in Austin, Texas and led the effort for drawMD. At Escalation Point, John had built a team of dedicated marketing, design, and engineering professionals focused on providing user-centric mobile and web applications for individual and corporate entrepreneurs, including McKesson and The Advisory Board Company. Prior to Escalation Point, John served in a variety of managerial and operational roles with Between Markets, Coremetrics, and Trilogy Software. 

John holds Masters and Bachelors degrees in Biomedical Engineering from the University of Texas and the University of Southern California, respectively, as well as an M.B.A. from the UCLA Anderson School. He resides in beautiful Austin, Texas, where he enjoys time with his family, running, poker, and someday hopes to take up golf.

In my roles at Visible Health and Escalation Point, I am fortunate to work closely with physicians and other clinical entrepreneurs who believe that technology can help cultivate collaborative relationships between clinicians and patients. There are a number of challenges in my day-to-day experiences with clinical entrepreneurs – bridging knowledge gaps, learning each other’s languages, being clear about expectations – that parallel the challenges that clinicians and patients face in their efforts to work more as a team. We believe that technology – by supporting the creation, capture, and communication of clinical context before, during and after interactions between providers and patients – will make this collaboration possible to the benefit of the individuals involved as well as the healthcare system as a whole.

John Cox
Co-Founder, President and Chief Executive Officer, Visible Health, Inc.
BARBARA-Ficcara.jpg
Barbara Ficarra, RN, BSN, MPA
Founder, Health in 30™ (Healthin30.com)
BARBARA-Ficcara.jpg

Barbara Ficarra, RN, BSN, MPA is founder of Healthin30.com, award-winning broadcast journalist, featured writer for The Huffington Post, health educator and health advisor. She is on the front lines of health care as a registered nurse and a leading nurse voice in health focusing on patient engagement and empowerment, healthy living, health care social media, digital technology (mobile health, gamification, telemedicine), and the doctor-nurse team.  

Ficarra began her broadcasting career in radio as creator, host and executive producer of the award-winning Health in 30® radio show. She is a member of the editorial advisory board and is a consumer health expert at Sharecare.com, and is the former senior director of clinical affairs for a telehealth company. She is a contributor to other health sites, medical blogger, freelance writer, and has been quoted as an expert in health care for multiple journals and magazines and has appeared on FOX News Live. 

Ficarra speaks internationally on issues surrounding health care focusing on patient engagement and empowerment, health care social media networking, digital technology and professional development. She served as faculty for the American Medical Association’s Medical Communications Conferences. She served on the board of the National Association of Medical Communicators, and served on the Academy of Judges for the International Health and Medical Media Awards. She is President of Barbara Ficarra Productions, LLC and is she is consultant, moderator, and media trainer. Healthin30 was voted Best Health Blog 2011 by Healthline. 

[@BarbaraFicarra |Healthin30.com | http://healthin30.com/ | http://www.facebook.com/Healthin30 ]

As a registered nurse, writer, broadcast journalist, and health educator, I’m dedicated to deliver accurate, reliable and trustworthy health and medical information. I’m committed to encourage patients and consumers to be proactive, engaged and in charge of their health. I share a nurses inside perspective on healthy living and personal health, and I sort through the latest research and provide consumers with relevant information without any of the confusing medical jargon. I’m also recognized in the professional arena and I speak internationally on the topics of digital technology (telemedicine, gamification and mobile health), health care social media networking, and patient engagement and empowerment.

Barbara Ficarra, RN, BSN, MPA
Founder, Health in 30™ (Healthin30.com)
DrKussin.jpg
Steven Kussin, MD
Founder of The Shared Decision Center in Utica, NY and the Author of Doctor Your Patient Will See You Now
DrKussin.jpg
Dr. Kussin is a physician, author, patient advocate and educator. He is the founder of a Shared Decision Center, writes a column for Utica’s weekly newspaper and appears regularly on its local NBC television affiliate.
 
He graduated magna cum laude and Phi Beta Kappa from Columbia College, went on to the Albert Einstein College of Medicine and the Memorial Sloan Kettering Cancer Center. Board certified in Internal Medicine and Gastroenterology he was an assistant professor of clinical medicine at Columbia and Einstein. During his teaching years, he published scholarly articles in a number of medical journals. His work was referenced by two major textbooks of Internal Medicine and Epidemiology.
 
He founded and managed one of New York’s largest GI practices until he left clinical care to write his book, Doctor, Your Patient Will See You Now (Rowman & Littlefield, 2011) His book was reviewed by The New York Times and was cited as one to the top ten health and wellness titles of 2011.
 
Dr. Kussin’s web site, MedicalAdvocate.com has an international following.
 
His proudest accomplishment is being the father of Zachary and Efrem and the life partner of his sweetheart,  Annie McGuirl. They have homes in central New York and Manhattan.
The quality of a clinician’s intellect is primary to medical care’s success. Yet, without communication skills, wisdom is useless. A locked library is not a resource, despite the knowledge contained within. A diagnosis means little if its significance and treatment is not effectively communicated. Compliance with even the best regimens will suffer if the patient is not given the opportunity to communicate their own unique goals, priorities and risk tolerance.
 
Forty years in medicine is a long time. But it took two life threatening personal experiences to end my clinical years. The time I spent both as a physician and a patient inspired me to write my book and to open a Shared Decision Center. What was my goal? To help correct the communication blackout that exists today between providers and health care consumers.
Steven Kussin, MD
Founder of The Shared Decision Center in Utica, NY and the Author of Doctor Your Patient Will See You Now
JosephKvedar.jpg
Joseph Kvedar, MD
Founder and Director, Center for Connected Health, Partners HealthCare
JosephKvedar.jpg

Joseph C. Kvedar, M.D., Founder and Director of the Center for Connected Health, Partners HealthCare, is creating a new model of healthcare delivery, developing innovative strategies to move care from the hospital or doctor’s office into the day-to-day lives of patients. 

Dr. Kvedar is leveraging information technology – cell phones, computers, networked devices and remote health monitoring tools – to improve care delivery. Based on the technology platform developed at the Center, Healthrageous, a personalized health technology company, was launched in 2010, creating a range of health and wellness self-management programs. He is a Co-Founder and Chair of the company’s Scientific Advisory Board. Dr. Kvedar established the first physician-to-physician online consultation service in an academic setting, linking patients from around the world with specialists at Harvard-affiliated teaching hospitals.

He is internationally recognized for his leadership and vision in the field of connected health, and has authored over 90 publications on the subject. Dr. Kvedar serves as a Board member for a number of organizations, including Care Continuum Alliance. He serves as a strategic advisor at Physic Ventures and West Health Institute, and is a mentor at Blueprint Health and Rock Health, providing guidance and insight to developing companies.

I have launched dozens of research studies and clinical programs using information technologies to help providers and patients manage chronic conditions, maintain health and wellness, and improve adherence, engagement and clinical outcomes. From a virtual relay race to get inner city kids more active, to remote monitoring for our sickest patients with heart failure, I focus on integrating these tools into clinical workflow and into the day-to-day lives of patients.

As a practicing physician, I conduct virtual visits with my patients and have seen, first hand, how personalized connected health strategies can change behavior, enhance patient self-care and improve outcomes.

Joseph Kvedar, MD
Founder and Director, Center for Connected Health, Partners HealthCare

Tweets #GreatChallenges

Challenge Team Perspectives

We selected 10 questions out of the many submitted by our Great Challenges Community, to be addressed by each of our Team members.
See their responses and perspectives, below.

Question 1

What are the top 10 contributing factors that result in medical communication being a complex and difficult problem for patients, doctors, the medical establishment and society in general…and how do these factors interact?
Response from John Cox

#GreatChallenges