Clinical Dialogue and Communication



We spend much of our waking time communicating with others, by speaking, writing, and through “body language.” Communication is a little like sex. It is a normal function and most of us think we are good at it and some are, but many aren’t. Superior clinical communication is a learned skill. Speaking with patients, families, and colleagues calls for a studied blend of selective curiosity, quiet intensity, and the ability to attend to what is not being said.


Clinical Interview Chief Complaint Narrative Competence Personal Injury Claim Medical Regulatory Authority 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Berger J. A Fortunate Man: The Story of a Country Doctor. New York: Random House; 1967:77.Google Scholar
  2. 2.
    Launer J. Narrative-based medicine: a passing fad or a giant leap for general practice? Br J Gen Pract. 2003;53(487):91–92.PubMedGoogle Scholar
  3. 3.
    Saito S. Narrative-based medicine and clinical knowledge. Seishin Shinkeigaku Zasshi. 2006;108(2):176–181.PubMedGoogle Scholar
  4. 4.
    Charon R. The patient-physician relationship. Narrative medicine: a model for empathy, reflection, profession, and trust. JAMA. 2001;286:1897–1902.CrossRefPubMedGoogle Scholar
  5. 5.
    Tamblyn R, Abrahamowicz M, Dauphinee D. Physician scores on a national clinical skills examination as predictors of complaints to medical regulatory authorities. JAMA. 2007;298:993–1001.CrossRefPubMedGoogle Scholar
  6. 6.
    Makoul G, Curry RH. The value of assessing and addressing communication skills. JAMA. 2007;298(9):1057–1059.CrossRefPubMedGoogle Scholar
  7. 7.
    Groopman J. How Doctors Think. New York: Houghton-Mifflin; 2007.Google Scholar
  8. 8.
    Kahn MW. Etiquette-based medicine. N Engl J Med. 2008;359(19):1988–1989.CrossRefGoogle Scholar
  9. 9.
    Seuss D. You’re Only Old Once. New York: Random House; 1986.Google Scholar
  10. 10.
    Haidet P. Jazz and the art of medicine: improvisation in the medical encounter. Ann Fam Med. 2007;5:164–169.CrossRefPubMedGoogle Scholar
  11. 11.
    Reik T. Listening with the Third Ear: The Inner Experience of a Psychoanalyst. New York: Farrar, Straus and Giroux; 1983.Google Scholar
  12. 12.
    Low CH. Reflection for young doctors and doctors of tomorrow. Singapore Med J. 1998;39(12):535–536.PubMedGoogle Scholar
  13. 13.
    LeBourgeois HS, Foreman TA, Thompson JW Jr. Novel cases: malingering by animal proxy. J Am Acad Psychiatry Law. 2003;31:394–395.Google Scholar
  14. 14.
    Ferguson WJ, Candib LM. Culture, language and the doctor-patient relationship. Fam Med. 2002;34(5):353–361.PubMedGoogle Scholar
  15. 15.
    Heritage J, Robinson JD, Elliott MN, Beckett M, Wilkes M. Reducing patients’ unmet concerns in primary care; the difference one word can make. J Gen Intern Med. 2007;22:1429–1433.CrossRefPubMedGoogle Scholar
  16. 16.
    White PD. Introduction. Clues in the Diagnosis and Treatment of Heart Disease. 2nd ed. Springfield, IL: Charles C. Thomas; 1956.Google Scholar
  17. 17.
    Feinstein AR. Clinical Judgment. Baltimore: Williams and Wilkins; 1967.Google Scholar
  18. 18.
    Stephens GG. A family doctor’s rules for clinical conversations. J Am Board of Fam Pract. 1994;7(2):179–181.Google Scholar
  19. 19.
    Lilford RJ. Medical practice-what next? J R Soc Med. 2001;94:560–565.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of Family Medicine School of MedicineOregon Health and Sciences UniversityPortlandUSA

Personalised recommendations