Effective Medical Communication: An Anthology of Columns

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© 2011 American Osteopathic Association. All rights reserved.

No part of this book may be reproduced, stored in a retrieval system, or transmitted by any means without the written permission of the author.

First published by AuthorHouse     5/12/2011

ISBN: 978-1-4567-2938-7 (sc)

ISBN: 978-1-4567-2937-0 (e)

Library of Congress Control Number: 2011902130

Printed in the United States of America

Because of the dynamic nature of the Internet, any web addresses or links contained in this book may have changed since publication and may no longer be valid. The views expressed in this work are solely those of the author and do not necessarily reflect the views of the publisher, and the publisher hereby disclaims any responsibility for them.

To my wonderful late wife,

Anita,

whose constant love, support and help

made me what I am.

Contents

Preface

Foreword

Acknowledgments

Learning to write

Medical Speaking

You’ve been asked to speak

Communicating with slides

Sharp … but dull

Formality equals formalin—in communication

Joke or no joke?

Be brief and be courteous

Know when to say no

Making your speech fit the time slot

It’s all in how you say it

‘I would like to introduce … ’

SOS in communication

SOS revisited—prevention

Medical Writing

Beware of Internet references: Part 1

Beware of Internet references: Part 2

Public health communication

Make your office handouts stand out

Jargon jive

Its they’re

What if you had to write a medical speech

Writing a medical speech for someone else

Shedding light on confusing word pairs

Medial errands

Tantalizing titles

Don’t write those ‘naughty’ words

Dear Colleagues:

High-fun hyphens

Suppress the sesquipedalians

Package inserts—medical camels

Decipher this: F U N E M N X? S, I F M N X. OK, I 1 2 F M N 2 X.

Shedding more light on more word pairs

O, name the –onyms

Rx—Crucial medical communication

Medical communication can be funny

‘Dictated, but not read by … ’

Preventing writer’s block

A common itch!

Serendipity and abbreviations

Write it down!

Patient Communication

Communicating with the adolescent patient

Learning from The Wall Street Journal

Communicating with little ones

Medical cell-ulitis

What did (s)he mean?

Your most important question

‘By their deeds shall ye know them’

The office: Communication by proxy

Telephone talk

What business are we in?

Let’s improve our office demeanor

Listen to the patient

Epiphany and communication

Better communication = fewer medical errors

Clients and patients

Sarcasm—a means of communication

Clothes do communicate in hospitals

Two openings—one wrong, one right

Epilogue

Preface

This is a collection of the columns on effective medical communication that I have been writing since September 2004 in The DO, the news and feature magazine of the American Osteopathic Association. Such an anthology serves a greater purpose than just putting a number of pieces of information into one volume. Reading a column monthly rarely provides much continuity. This book serves to bring together a greater overview of medical communication, organizes it by theme rather than by chronology, and allows for a permanent reference.

After many years in pediatric practice and some years in medical school administration, I have become convinced that communication in is one of the most important components of medical practice. It bears heavily on the success of medical care and on the satisfaction of both health care professionals and patients. Thus, I chose medical communication as my third career—almost inadvertently.

Just exactly what is medical communication? There’s no exactly to it. It consists of everything transmitted by medical and other health professionals to patients and their families—and to other health workers—plus everything communicated in the other direction, by whatever means is available.

For convenience, I have divided the field into three categories: first, Medical Speaking—communicating information by professional lecturing and teaching; second, Medical Writing—any written word on health topics, including published articles intended for either a professional or lay audience; and third, Communicating With Patients—the interactions between health professionals and patients (and their families) in either direction. You will find considerable overlap among the categories, but that is natural. In many cases, the topics cannot be strictly separated by theme. In these categories, all medical communication occurs, sometimes by language and sometimes by nonverbal communication, such as body language, behavior, physical surroundings and other means.

This book is really a work in progress. Each topic I present often stimulates both the writer and the reader to think of another topic—or two or three—that could be discussed. So like medicine and health care themselves, there is never an end point, only a pause, because there are always further considerations. That’s what makes a work in progress.

With that, I give you some of my views on effective medical communication.

Foreword

When Arnold Melnick, DO, asked me to write the foreword for this book, I quickly said yes. Not only did I believe strongly in the value of the book’s content, but also I wanted to be in the company of two wonderful and highly respected physicians—C. Everett Koop, MD, a former surgeon general of the U.S. Public Health Service, and Gary Fleisher, MD, physician-in-chief of pediatrics at Children’s Hospital Boston—colleagues of Dr. Melnick’s who have written the forewords for two of his previous books. In fact, Dr. Melnick has published six highly effective books and more than 200 articles, many of which deal with a variety of pediatric and physician communication issues.

As a former president of the American College of Osteopathic Pediatricians and the American Medical Writers Association, Dr. Melnick is an experienced writer and sought-after public speaker, as well as a nationally known leader in pediatrics. Dr. Melnick was the founding dean of the Southeastern College of Osteopathic Medicine, which became the Nova Southeastern University College of Osteopathic Medicine in Fort Lauderdale, Fla. He is also the founder and a former chairman of pediatrics at two hospitals in Pennsylvania. For his numerous accomplishments, Dr. Melnick has been recognized by the American Osteopathic Association (AOA) as one of its Great Pioneers in Osteopathic Medicine, and he received the AOA’s highest honor, the Distinguished Service Certificate, in 2002.

As the AOA’s editor in chief, I have read every column that Dr. Melnick has submitted to be published in our profession’s news and feature magazine, The DO. Effective Medical Communication is an organized compendium of these personal, funny yet substantive writings.

I, like many readers, waited each month to read his column. In fact, I have used Dr. Melnick’s right-on-target advice on numerous occasions: while caring for patients, speaking publicly, dictating charts, and writing my own articles. His experience and knowledge in this area is vast, and his advice is practical and timeless. He has helped me step up my game, and I’m sure he will do the same for you.

Gilbert E. D’Alonzo Jr., DO

AOA Editor in Chief

What are DOs?

For those readers who are unfamiliar with osteopathic medicine, osteopathic physicians are fully qualified physicians who hold DO degrees, rather than MD degrees. Osteopathic physicians practice in all of the same specialties as MDs, and like MDs, DOs are licensed by state medical boards to prescribe medication and perform surgery.

Osteopathic physicians have a different philosophy of medicine—and attend different medical schools—than do MDs. DOs practice a whole person approach to medicine. Instead of just treating patients for specific symptoms or illnesses, they regard the body as an integrated whole.

DOs receive training in the musculoskeletal system—the body’s interconnected system of nerves, muscles and bones that makes up two-thirds of patients’ body mass. This training provides osteopathic physicians with a better understanding of how an illness or injury in one part of a patient’s body can affect another part.

Many DOs incorporate a form of manual medicine called osteopathic manipulative treatment (OMT) into their care of patients. With OMT, osteopathic physicians use their hands to diagnose illness and injury and to encourage the body’s natural tendency toward good health. By combining all other available medical options with OMT, DOs offer their patients the most comprehensive care available in medicine today.

To learn more about DOs and the kind of medicine they practice, readers can visit the American Osteopathic Association’s Web site at www.osteopathic.org.

Acknowledgments

I am indebted to so many individuals—lay and professional—who have contributed to my career that it would be impossible to list them all. Some of them I have acknowledged in previous books. But to all of them—every single person—I offer my sincerest gratitude and a heartfelt thank you!

For this book, I am extremely grateful to the American Osteopathic Association (AOA) for its official sponsorship. The endorsement by the osteopathic medical profession’s national professional association means more than just editorial help—I am truly honored.

This project would not have been possible without the sincere and dedicated editorial help given to me for each column and for this book by Carolyn Schierhorn, the senior editorial project manager for the AOA Department of Publications, who has served as my personal editor from the beginning. I thank her profusely. Also, I thank Patrick Sinco, The DO’s managing editor, for his constant—and learned—input through all the years. Michael Fitzgerald, the always cooperative and helpful publisher of The DO, is responsible for all aspects of getting this book published. Far from last, I am deeply indebted to Gilbert E. D’Alonzo Jr., DO, the AOA’s editor in chief, without whose approval I would never have been an AOA columnist, nor would this book have been published. I appreciate his assistance throughout.

I wrote a column some time ago about a series of AOA editors who contributed so much to my journalistic career ever since I went into practice. They taught me a great deal about writing and editing. It is fitting to include that column on the next page as the first entry in this collection, acknowledging their immense help.

Arnold Melnick, DO

This column first appeared in The DO magazine in April 2005

Learning to write

In your mind, you’re saying to me, You are a DO. I know you didn’t major in journalism. I know you didn’t major in English or take any special courses. So how did you learn to write?

With apologies for assuming that I did learn to write, I would say there are three major essentials. First, there probably is something within writers that compels them to attempt to write in the first place. Second, one learns to write by writing—you know, practice, practice. And third, writers need to have over the course of their careers good editors, because every good editor teaches you something every time your manuscript is reviewed.

My first venture in writing was a short play for Sunday school at age 12—longhand, on lined paper. (On discovery of that paper years later, I found not a single error in grammar or punctuation.) Something inside must have driven me. I certainly have no memory of a wish to become a writer. I guess I was building on that inner impulse when I undertook to do a great deal of writing—in school, college and medical school and in my professional career. Most of my life’s writing has been in or tangential to my career as a physician.

I’ve been lucky to have had many editors critique my work, from English teachers to executives of major publications—and just about every one taught me something. I am extremely proud that many of them were editors of osteopathic medical publications.

AOA editors remembered

I’ve been fortunate to know every AOA editor from 1945 (my graduation) to the present. All were great, and I had outstanding experiences with several of them—the ones I worked most closely with during my most productive years.

In later years, Thomas Wesley Allen, DO, MPH, took over as editor, succeeded by the present AOA editor in chief, Gilbert E. D’Alonzo Jr., DO. Tom is a good friend of mine, but I did not have much chance to work with him. I have just started to work with Gil D’Alonzo. From observing their work from afar and seeing their product, I think they