April 2021 Communication Tip
Communication as Procedure
Many of us are familiar with medical procedures—a specific set of actions that require knowledge, skills, preparation, a specific set of steps and pause points.
Communication can be considered a “medical procedure” as well, especially some specific communication tasks, such as breaking bad news or discussing goals of care.
Josh Lakin, James Tulsky, and Rachelle Bernacki (currently at the Dana-Farber Cancer Center, but all formerly at UCSF!) have recently written about Communication as Procedure in a short piece entitled “Time out Before Talking” (Ann Intern Med, 2021;174, 96).
Like physical procedures, communication procedures:
- require specialized skills
- have component steps
- are chosen intentionally and with purpose
- require preparation
- and can have complications
Over the course a career, clinicians perform communication procedures much, much more frequently that other medical procedures such as lumbar punctures or surgery.
Like all skills, communication must be practiced, deliberate, and is available for feedback, correction, and improvement. But, it doesn’t mean that communication can be considered straightforward or automatic.
As Dr. Lakin conclude: “Skilled communication requires nuance, adjustment, and careful thought in complex interpersonal interactions. Just as surgery is a technical intervention and a practiced art form, communication procedures require both thoughtful structure and flexible skill.”
Keep on practicing!
Best,
Mike