Communication and counseling in health care

Patient Education and Counseling, 7 (1985) Elsevier Scientific Publishers Ireland Ltd.



Communication and Counseling in Health Care, Vincent M. Riccardi, M.D. and Suzanne M. Kurtz, PhD. Charles C. Thomas, Publisher, Springfield, IL 1983. There is an art to communication and it’s quality should be appreciated by those working the health care field. In their book ‘Communication and Counseling in Health Care’, a physician and a communication specialist blend their expertise, raising the consciousness of health care professionals about their communication patterns with patients. The authors suggest that clinicians are not just subject to passive spontaneous interactions in their work with patients, but can rely on predictable measures and skills to influence communication in a desired direction enhancing patient care. The clinician is offered a theoretical perspective as well as practical implications which may be applied to his or her own practice. In the beginning chapters, this book presents general concepts and models basic to universal communication. This overview provides the basis for a more focused discussion about communication specific to health care interactions. The authors first present their conceptual outline of components essential to effective clinical communication discussion goals, tasks and skills common in health care encounters. Clinicians are encouraged to use a systematic approach; to plan ahead based upon their desired outcome. Then practical guidance with interviewing technique is offered to readers. There is in depth coverage of what will contribute to a useful and supportive interview in a health care setting. Improving skill and ability when gathering information from a patient, relationship-building and providing information are all discussed extensively. There is emphasis on what is verbalized in an encounter as well as what is not verbalized but is of critical importance in communication. This book is written in a well organized fashion and the points made are supported by clear examples applicable to clinical practice. A strong point of this book is it’s respect toward patients as human beings. Compassion in caregiving and sensitivity to patients as persons is a constant theme emphasized throughout and ending with an epilogue entitled ‘A Place for Love’. Furthermore, this book is an important contribution toward treating the total patient and not just a presenting physical problem, which is a valuable and productive approach in achieving good patient care. During a crisis, the opportunity exists to enhance the potential for human growth and development through the use of good communication skills. This


book is of great value to the clinician wishing to achieve positive meaning with even the most difficult communication challenge. ‘Communication and Counseling in Health Care’ would have special appeal to those involved in teaching communication skills to clinicians. The book, however, defines ‘Clinician’ in a broad sense and aims to assist a variety of professionals communicating on many levels in the field of health care. Joanne S. Feldman, M.S. W., A.C.S. W., Clinical Social Worker, National institutes of Health, Bethesda. MD. U.S.A.

Medical Ethics -- A Patient-Centered Approach, James E. Giles. Schenkman Publishing Company, Cambridge, MA, 1983. As Mr. Giles describes it, medical ethics is concerned with problems of confidentiality, truth-telling and informed consent, as well as medical experimentation and death and dying, which he relates to both the competent and incompetent person. He concludes with ethical problems of psychosurgery and organ transplantation, and a final chapter on his goal to develop more patient autonomy. It is not clear to whom this book is directed, but it is written in language suitable for a college-educated person. The only indication of the background of the author is a brief thank you to Jono College and one of its officials (addressed as ‘Brother’) included in the introduction. The author characterizes himself as an ethicist. Most of the references cited are from the mid-seventies; the latest found was 1979, which seems inappropriate in a rapidly changing field. The living will is mentioned once and, while his discussion is better than most, it is not up to date. There is nothing about surrogate parenthood, embryo transplants nor the current activities of institutional review boards and informed consent required in the clinical trials program supported by the National Cancer Institute. The author places himself in the position of judge and jury, as he indicates what is correct. While decrying paternalism by the medical profession (I agree it can be criticized), the author provides numerous examples of his own paternalism. He denies any prejudice against medicine but establishes his own concept of a doctor and uses outmoded cliches, such as, i.e. ‘doctors are only interested in curative medicine .? While properly stressing the need for individual responsibility, he fails to indicate how people will obtain the expert information needed to make decisions. He suggests indirectly that laetrile enthusiasts might provide some such useful information. The author forgets that most of the progress in preventive medicine comes from medical science. He does not help those of us who find that the greatest barrier to developing better patient understanding is the patient’s family, 98