The importance of patient-doctor communication was studied as early as 1907. Studies suggest that physician sensitivity - specifically a doctor's interest in people - results in greater patient confidence and increased adherence to treatment regimens. We have much more confidence in our doctor if he or she can communicate with us and seems sensitive to our needs. Other studies have shown that most medical school training produces physicians who are less sensitive and more cynical. A few medical schools have begun to teach doctors to improve their verbal and nonverbal communication skills. Medical students at the University of Arizona College of Medicine have been getting sensitivity training in an unusual way. The class "Medicine & Horsemanship: An Introduction to Human Nonverbal Interaction at the Bedside" teaches them to improve their communication with patients by teaching them to communicate with horses. Dr. Hamilton is a Harvard-trained neurosurgeon who specializes in brain and spinal cord tumors. He created this course to help young physicians learn how to handle difficult moments such as when a parent needs to be told their child has died, or when a patient has to be told of a bad outcome on a test.
"I am not equating patients with horses," Dr. Hamilton stressed. "However, horses can teach us a great deal about nonverbal communication that is applicable to our interactions with patients. Horsemanship requires the understanding of body language and sensitivity," he said. "There is no endeavor that will more quickly and effectively teach you awareness of your own body language and energy level than learning the principles of working with horses. You learn patience, gentleness and a method of physically relating to patients that is nonverbal, effective and powerful."
This unique method of teaching physician sensitivity may not catch on at other medical schools, but the need for communication and sensitivity training is clear. A 1976 study found that physicians spent an average of one minute giving advice and information in a 20 minute office visit. When these physicians were asked to estimate the time that they had spent giving advice and information, they estimated 8-10 minutes.
One impact of managed care has been the shortening of office visits. When was the last time your family doctor spent 20 minutes with you? Physician sensitivity and communication skills are even more important in this this era of briefer visits. I doubt that horses will become a standard part of most medical training. I hope that some form of physician sensitivity and communication training does get incorporated into more medical schools.
