Compassionate communication in medicine

6 April 2022

Communication is a key skill in medicine and health care. Much of the care provided by doctors relies on excellent communication with patients and others involved in the care of each patient. Good communication in health care is clear, compassionate and kind.

Compassion is conveyed by the words we use, tone of voice and language as well as by non-verbal communication such as gestures and facial expressions. Compassion does not exclude, when appropriate, firm instruction or direction, but important messages can be conveyed in a calm manner without a raised or angry voice.

If anger or negative emotions are conveyed in communication through a loud or shouting voice or through harsh criticism or unpleasant language, the recipient of the message will not comprehend what is being conveyed. This is because of a stress response in the person receiving the message. Amygdala hijack activates the fight or flight response which impairs the frontal lobes of the brain and so reduces comprehension and a logical response.

The need for compassion and kindness extends beyond speaking to patients and those in our care and must include their families, colleagues, other healthcare workers, receptionists and administrative staff, car parking attendants and cleaners – in fact, anyone we encounter. Using a person’s name and greeting them with a genuine smile improves the day for both of you. Be friendly and authentic in all communication and build rapport by being personable.

Compassionate communication helps people remain empathetic with each other, even in situations fraught with anger or frustration. It allows each party to understand the other point of view even when they disagree.

Key steps for compassionate communication include:

1. Listening to hear – focus on what the person is saying without preparing a response. Listen without interrupting for at least 3 minutes to allow a full message to be conveyed.

2. Show that you have heard and understood by paraphrasing what was said and acknowledge and validate any emotion they have expressed.

3. Explain your viewpoint including any evidence. Note points of agreement.

4. Look at the person and meet their gaze when you are listening and when you are speaking. Consider any cultural customs about eye contact and avert your gaze if necessary but keep looking in their direction to show that you are focused on communicating with them.

5. Keep an open posture. Do not cross your arms or put your hands on your hips.

6. A light touch on a shoulder or hand may be appropriate to show empathy. Holding the hand is a sign of comfort. Such gestures can be used in established relationships or when gauged appropriate to circumstances.

7. As the conversation comes to a close, seek feedback and ask if they have any questions

Compassionate and kind communication must extend to providing feedback to colleagues who require supervision, teaching or guidance. Feedback needs to be constructive. There is no benefit in demeaning a colleague who needs to improve. Rather tell them what was good and what needs to improve. Feedback needs to be explicit and specific with practical examples. Talk about what to improve and explain how to develop the necessary skills.

There are many benefits from compassion and kindness in healthcare, including:

1. Improved satisfaction rates from patients and families.

2. Better morale and productivity reported from healthcare workers.

3. A better learning environment for doctors-in-training and other healthcare professionals.

4. Increased patient cooperation and adherence to treatment.

5. Better care and improved patient outcomes.

6. Fewer errors and a reduction in complaints.

7. More efficient provision of care and reduced costs.

8. Enhanced reputation of the health service which will attract both patients and staff.

Self-compassion and forgiveness are also essential. We are not always going to get it right, and that is ok. We can’t cultivate compassion towards others if we’re not compassionate with ourselves. It is also essential to have healthy boundaries to avoid compassion fatigue and burnout.

Kay Dunkley
AMA Victoria Coordinator of Doctor Wellbeing

Resources and further reading

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