ASCO issues guidelines on physician-patient communication


Your sitemaster is uncertain whether to feel delighted or seriously concerned by the fact that the American Society for Medical Oncology (ASCO) has decided to issue guidelines for its members on how to communicate with patients.

Either way, the entire text of this new guideline (“Patient-clinician communication: American Society of Clinical Oncology consensus guideline“) has been published in the Journal of Clinical Oncology and is freely accessible on line. Many of our readers may wish to download and read a copy of this set of guidance for themselves. It is obviously not specific to prostate cancer, but much of the guidance offered is highly relevant to conversations between patients and physicians about prostate cancer.

At the very least, it would be worth looking at the summary table entitled “The bottom line” on pages 2 to 4 of the article.

So why is your sitemaster not sure how to feel about the need for such a set of guidance?

Well, one the one hand, the ability to ensure a complete and accurate exchange of information between a doctor and his or her patient is fundamental to the principles of good medical practice and high quality medical care. Thus, in his naivety, your sitemaster had assumed that anyone who graduates from medical school and subsequently gains a license to practice medicine (they are two different things) would actually have been thoroughly trained — along the way — in the art and the science of patient-clinician communication and would have achieved a sophisticated appreciation of how to manage this process in the best interest of both patients. Alas, it appears that this has not been the case:

In the past, communication skills were often viewed as innate or else as something people acquired by mimicry of role models. To a large extent, clinicians were simply expected to figure it out on their own.

On the other hand, however, what one now needs to know in order to graduate from medical school and gain a license to practice medicine has become so overwhelming, in terms of the sheer quantity of essential information, that your sitemaster has often wondered to what extent communications skills have “got lost” in all the essential detail. Maybe that is exactly what has been happening!

So far, your sitemaster has only had the chance to glance relatively quickly though the article. He reserves the right to comment further after a more thorough read. However, based on the quick glance through the article, much of the guidance offered by Gilligan et al. in this set of guidelines would be applicable to any physician with responsibilities related to the discussion of any form of cancer with any patient — not just to medical oncologists.

2 Responses

  1. I will try to look at this. Until recently no doctor in Amsterdam communicated adequately with me, and until I left oncology for urology in Uppsala only one doctor did. She helped save my health and probably life; one other adversely affected it. The urologists are fine and communicate well.

  2. Communication skills are personal tools that can be acquired and, I believe, are not on the priority list of doctors; at least not in the short term.

    A regular appointment with a public health doctor takes approximately 15-20 minutes, not enough to implement this list of communication good wishes.

    Regards from Monterrey. MEX.

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