Effective communication is an integral part of a successful relationship, especially between healthcare providers and their patients. Being able to communicate effectively is an art that has an array of benefits, the most important one is to deliver patient centered and quality care. This paper aims at reflecting an unfortunate circumstance that I have encountered due to ineffective communication.
Communication between a patient and a doctor is always a challenging one, especially while making treatment related decisions. These challenging interactions always occur due to discrepancies in perception of the information. However, when sensitive situations arise verbal communication becomes extremely important. I would like to describe one such incident that occurred. This incident occurred three years ago during my internship at a well-renowned dental hospital in India. On a remarkably busy day an elderly female patient with persistent toothache presented to our clinic. I was asked to explain the treatment procedure to her by my chief. The treatment plan was to extract the tooth as it was grossly damaged. I started elaborating on the procedure and told her that the tooth must be removed. Since she was from a different state, she was unable to communicate in English nor the regional language of our state. Initially she agreed to the procedure, and it seemed like she was aware of what was going to be done for her but once we prepared her for the procedure and about to give her local anesthetic, she became anxious and frustrated. I later realized that the patient was not convinced by the treatment plan and did not want the tooth extracted, as we had proposed, because she had done some previous research and demanded treatment that did not involve tooth removal. She also complained to my chief saying that I did not pay attention to her needs and proposed a wrong plan. I was shocked by her actions and words and felt extremely disappointed as she threatened to take legal action against our clinic. I did not want to impair the clinic’s name because of this situation.
Within the described communication scenario, the language barrier between me and the patient became the key barrier. First of all, as indicated above, neither English nor a local language could be used to have a thorough discussion. The patient showed some knowledge in English, which clearly did not suffice for full communication in a clinical setting. However, we tried to understand each other using our native languages, which, despite some similarities, still had major differences. Furthermore, my speech involved a series of professional terms, which contributed to the misunderstanding, making the verbal element of interaction flawed. It is equally possible that the paraverbal aspect lacked clarity, as well. In the presentation, the speed of the speech is listed among the key paraverbal communication features. I tend to speak rather quickly, which may also cause a lack of comprehension, since the patient’s command of the language was limited.
Second, the demographic differences of the interlocutors play a role of paramount importance in the process of communication. The patient was over 50 years old, making the generation gap between us considerable enough to have an impact on the interaction. Having completed the assessment of the situation, it was a medically justified decision to remove the damaged tooth from the patient’s mouth. Nevertheless, she objected to the procedure and insisted on an alternative approach. Perhaps, my approach to communication involved a degree of dogmatism, mentioned as a harmful habit by the author of the HAIL paradigm (Week 5, 2022). I spoke with elevated confidence, as the subject matter belonged to my professional domain. Had I taken a more lenient position toward the preferences of the patient, the situation could have been resolved without a conflict. I would not be obliged to abandon my initial tooth removal plan, but we would have had more time to convince the patient of its necessity. With a degree of dogmatism present, the other party is likely to respond aggressively, taking an opposing stance by default even when the facts are against it.
Third, the physical aspect of this communication was impeded by objective hearing and comprehension difficulties. As described above, the patient relied on her mother tongue to interact with the clinical staff. Even though it had certain lexis in common with my native language, the understanding was not complete. It is possible that the patient experienced a similar effect, as well. Thus, I had to make increased physical effort to distinguish the familiar words, especially when their pronunciation was different. In addition to that, the room had much background noise from the adjacent offices. Under such circumstances the already impaired comprehension deteriorated even more. As a result, the communication was not successful at all.
Overall, this failure had a strong impact on my communicative behavior due to its potential consequences for the clinic and me, personally. The patient and I did not manage find common ground during this discussion, which was particularly serious because of the medical nature of the conversation. The woman needed help with her teeth, and I was required to provide her with a thorough explanation of what is to be done and why it is so. As per the knowledge provide in lecture two, self-awareness is the key to successful communication. In this case, I was not aware of the situation in its entirety and only identified and addressed the barriers above in retrospect.
Under such circumstances, I would have benefited from a stronger reliance on non-verbal communication techniques, since the verbal aspects were objectively impaired. For example, it was possible to begin by speaking more slowly so that the patient would be more likely to understand me, thus modifying the speed factor. Next, with clear language difficulties involved, we could have used more gestures to deliver our messages with better clarity. These actions would have done calmly and with a smile to demonstrate the benevolence and respect (Week 2 lecture, 2022). This way, communication would have more chances of success through the use of non-verbal elements, empathy, and bond.
References
Week 2 lecture – Barriers to communication and the role of self-awareness in interpersonal communication. (2022). COMM8130 [PowerPoint Slides].
Week 5: Verbal communication skills. (2022). COMM8130 [PowerPoint Slides].