Deciphering the Optimum Doctor-Patient Communication Strategy During COVID-19 Pandemic

Excerpt

“Face is the index of mind.”

The old Latin proverb forms the essence of effective doctor-patient communication. Appropriate communication and interpersonal skills enable a doctor to acquire information critical for diagnosis, counselling, providing therapeutic instructions, and establishing a rapport with patients. Information exchange is an essential component of a communication model which incorporates shared decision-making and patient-centred communication. This becomes especially important for doctors involved in providing cancer care, where breaking the bad news is an art to be mastered over time considering the bleak treatment prospects and the stigma associated with the disease [1, 2]. The current COVID-19 pandemic has strained this vital doctor-patient relationship due to the potential risk of transmission of SARS-CoV-2 infection from each other. Several steps have been recommended to mitigate this risk—wearing a facemask and ensuring physical distance are few of them. However, covered faces are known to interrupt the non-verbal communication which constitutes almost 93% of our interpersonal communication [3]. Facial expressions are used—voluntarily or involuntarily—to express the emotions; however, facemasks have made it almost impossible for the doctors to use facial expressions, even purloined a smile, to convey our concerns, empathy, and willingness to support to the patients—it poses a challenge to non-verbal communication. Remember, a doctor’s facial expressions are usually the first thing a patient notices. A randomised controlled trial highlighted that wearing facemasks by the doctors can result in a significant negative effect on the patient’s perception of the doctor’s empathy [4]. Furthermore, physical distancing which prohibits proximity and use of haptics (communication using touch) is another potential barrier to non-verbal communication. A gentle pat on the shoulder of the patient or touching her hands by the doctor extends support and empathy. COVID-19 pandemic has, albeit literally, robbed doctors of this opportunity to help build mutual trust with the patient. Another essential pillar of effective patient communication is assessing the state of mind of the patient. Again, the use of facemasks hides the expressions of patients which can serve as useful cues to gauge patients’ emotional status and perspectives. Hence, it is also essential for a doctor to have an eagle eye to grasp the subtle signs which may be representative of the patient’s state of mind and manifested via the bodily gestures or expressed through the uncovered facial subunits and form a continuous loop of feedback essential for a two-way communication process. …