Communication and Interpersonal Skills

  • Wayne T. Dodge


Everyone practices the skill of communication daily. From the first expression of dissatisfaction with the birth trauma, individuals are exploring, developing, and perfecting ways with which they share information with others. Over years of experimentation they adopt methods of communicating that reflect their individual personalities and past experiences.1 These highly personalized styles of communication hold a central place in the practice of the art and science of medicine. Physicians need to appreciate the rich and varied ways in which patients express themselves. They also must be aware of their own style of communication and its effect on patients.


Explanatory Model Nonverbal Communication Interpersonal Skill Biopsychosocial Model Communication Breakdown 
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  1. 1.
    Watzlawick P, Beavin JH, Jackson DD: Pragmatics of Human Communication: A Study of Interactional Patterns, Pathologies and Paradoxes. New York, WW Norton, 1967.Google Scholar
  2. 2.
    Inui TS, Carter WB, Kukull WA, Haigh VH: Outcome-based doctor-patient interaction analysis. Med Care I, II. 20: 535–566, 1982.CrossRefGoogle Scholar
  3. 3.
    Reader GG, Pratt L, Mudd MC: What patients expect from their doctors. Mod Hosp 89: 88–94, 1957.PubMedGoogle Scholar
  4. 4.
    DiMatteo MR, Prince LM, Taranta A: Patients’ perceptions of physicians’ behaviors: Determinants of patient commitment to the therapeutic relationship. J Community Health 4: 280–290, 1979.PubMedCrossRefGoogle Scholar
  5. 5.
    Eisenberg L: The search for care. Daedalus 106: 235246, 1977.Google Scholar
  6. 6.
    Stimson GV: Interaction between patients and general practitioners in the United Kingdom. In: Gallagher EB (ed.) The Doctor-Patient Relationship in the Changing Health Scene. USDHEW(PHS,NIH) DHEW Pub No. (NIH) 78–183, 69–84.Google Scholar
  7. 7.
    Snyder D, Lynch JJ, Gross L: Doctor-patient communication in private family practice. J Fam Pract 3: 27 1276, 1976.Google Scholar
  8. 8.
    Hulka BS, Kupper LC, Cassel JC, Mayo F: Doctor-patient communication and outcomes among diabetic patients. J Community Health 1: 15–26, 1975.PubMedCrossRefGoogle Scholar
  9. 9.
    Waitzkin H, Stoeckle JD: The communication of information about illness: Clinical, sociological and methodological considerations. Adv Psychosom Med 8: 180–215, 1972.PubMedGoogle Scholar
  10. 10.
    Wolraich ML, Reiter S: Training physicians in communication skill. Develop Med Child Neurol 21: 773–778, 1979.PubMedCrossRefGoogle Scholar
  11. 11.
    Korsch BM, Gozzi EK, Francis V: Gaps in doctor-patient communication. Pediatrics 42: 855–871, 1968.PubMedGoogle Scholar
  12. 12.
    Duff RS, Hollingshead AB: Sickness and Society. New York, Harper & Row, 1968.Google Scholar
  13. 13.
    Doyle BJ, Ware JE: Physician conduct and other factors that affect consumer satisfaction with medical care. J Med Educ 52: 793–801, 1977.PubMedGoogle Scholar
  14. 14.
    KastelerJ, Kane R, Olsen D, Thetford C: Issues underlying prevalence of “doctor-shopping” behavior. J Health Soc Behav 17: 328–339, 1976.CrossRefGoogle Scholar
  15. 15.
    Cobb B: Why do people detour to quacks? Psychiat Bull 3: 66–69, 1954.Google Scholar
  16. 16.
    Gallagher EB: Conference background and objectives. In: Gallagher EB (ed.) The Doctor-Patient Relationship in the Changing Health Scene. USDHEW (PHS,NIH) DHEW Pub No. (NIH) 78–183, 1–7.Google Scholar
  17. 17.
    Davis MS: Variations in patients’ compliance with doctors’ orders: Analyses of congruence between survey responses and results of empirical investigations. J Med Educ 41: 1037–1048, 1966.PubMedGoogle Scholar
  18. 18.
    Stimson G: Obeying doctor’s orders: A view from the other side. Soc Sci & Med 8: 97–104, 1974.CrossRefGoogle Scholar
  19. 19.
    Francis V, Korsch BM, Morris MJ: Gaps in doctor-patient communication: Patients’ response to medical advice. N Engl J Med 280: 535–540, 1969.PubMedCrossRefGoogle Scholar
  20. 20.
    Scheffe TJ: Emotion work and distancing in medical settings. In: Gallagher EB (ed.) The Doctor-Patient Relationship in the Changing Health Scene. USDHEW (PHS,NIH) DHEW Pub No. (NIH) 78–183, pp. 105117.Google Scholar
  21. 21.
    Antonovsky A, Hartman H: Delay in the detection of cancer: A review of the literature. Health Educ Monogr 2: 98–126, 1974.CrossRefGoogle Scholar
  22. 22.
    Alpert JJ: Broken appointments. Pediatrics 34: 127132, 1964.Google Scholar
  23. 23.
    Ben-Sira Z: The function of the professional’s affective behavior in client satisfaction: A revised approach to social interaction theory. J Health Soc Behav 17: 311, 1976.CrossRefGoogle Scholar
  24. 24.
    Jarvinen KAJ: Can ward rounds be a danger to patients with myocardial infarction? Br Med J 1: 318–320, 1955.PubMedCrossRefGoogle Scholar
  25. 25.
    Lynch JJ, Thomas SA, Mills ME, Malinow K, Katcher AH: The effects of human contact on cardiac arrhythmia in coronary care patients. J Exp Soc Psychol 11: 155–165, 1975.CrossRefGoogle Scholar
  26. 26.
    Egbert LD, Battit GE, Welch CE, Bartlett MK: Reduction of postoperative pain by encouragement and instruction of patients: A study of doctor-patient rapport. N Engl J Med 270: 825–827, 1964.PubMedCrossRefGoogle Scholar
  27. 27.
    Skipper JK, Leonard RC: Children, stress, and hospitalization: A field experiment. J Health Soc Behav 9: 275–287, 1968.PubMedCrossRefGoogle Scholar
  28. 28.
    Morgan WL, Engel GL: The clinical approach to the patient. Philadelphia, Saunders, 1969.Google Scholar
  29. 29.
    Byrne PS, Long BEL: Doctors Talking to Patients: A Study of the Verbal Behaviour of General Practitioners Consulting in Their Surgeries. London, Her Majesty’s Stationery Office, 1976.Google Scholar
  30. 30.
    Froelich RE, Bishop FM: Clinical Interviewing Skills. St Louis, Mosby, 1977.Google Scholar
  31. 31.
    Smith CK, Leversee JH: Basic interviewing skills. In: Rosen GM, Geyman JP, Layton RH (eds.) Behavior Science in Family Practice. New York, Appleton-Century-Crofts, 1980, pp. 109–121.Google Scholar
  32. 32.
    Brammer LM: The Helping Relationship: Process and Skills. 2nd ed. Englewood Cliffs, Prentice-Hall, 1979.Google Scholar
  33. 33.
    Cassell EJ: The Healer’s Art: A New Approach to the Doctor-Patient Relationship. New York, Penguin Books, 1976.Google Scholar
  34. 34.
    Maguire GP, Rutter DR: History-taking for medical students. I. Deficiencies in performance. Lancet 2: 556–558, 1976.PubMedCrossRefGoogle Scholar
  35. 35.
    Stiles WB, Putnam SM, Wolf MH, James SA: Interaction exchange structure and patient satisfaction with medical interviews. Med Care 17: 667–679, 1979.PubMedCrossRefGoogle Scholar
  36. 36.
    Marks J, Goldber D, Hillier V: Determinants of the ability of general practitioners to detect psychiatric illness. Psychol Med 9: 337–354, 1979.PubMedCrossRefGoogle Scholar
  37. 37.
    Kessel N: Reassurance. Lancet 1: 1128–1133, 1979.CrossRefGoogle Scholar
  38. 38.
    Blondis MN, Jackson BE: Nonverbal communication with patients. New York, Wiley, 1977.Google Scholar
  39. 39.
    Friedman HS: Nonverbal communication between patients and medical practitioners. J Soc Issues 35: 8299, 1979.Google Scholar
  40. 40.
    DiMatteo MR: A social-psychological analysis of physician-patient rapport: Toward a science of the art of medicine. J Soc Issues 35: 12–33, 1979.CrossRefGoogle Scholar
  41. 41.
    Sherer M, Rogers RW: Effects of therapist’s nonverbal communication on rated skill and effectiveness. J Clin Psychol 36: 696–700, 1980.PubMedCrossRefGoogle Scholar
  42. 42.
    Leathers DG: Nonverbal Communication Systems. Boston, Allyn & Bacon, 1976.Google Scholar
  43. 43.
    Freemon B, Negrete VF, Davis M, Korsch BM: Gaps in doctor-patient communication: doctor-patient interaction analysis. Pediatr Res 5: 298–311, 1971.CrossRefGoogle Scholar
  44. 44.
    Pratt L, Seligmann A, Reader G: Physicians’ views on the level of medical information among patients. Am J Public Health 47: 1277–1283, 1957.CrossRefGoogle Scholar
  45. 45.
    Davis MS: Variations in patients’ compliance with doctors’ advice: An empirical analysis of patterns of communication. Am J Public Health 58: 274–286, 1968.CrossRefGoogle Scholar
  46. 46.
    Ley P, Spellman MS: Communication in an out-patient setting. Br J Soc Clin Psychol 4: 114–116, 1965.PubMedCrossRefGoogle Scholar
  47. 47.
    Ley P: Communication in the clinical setting. Br J Orthodont 1: 173–177, 1974.Google Scholar
  48. 48.
    Ley P, Whitworth MA, Skilbeck CE, et al.: Improving doctor-patient communications in general practice. J Roy Coll Gen Pract 26: 720–724, 1976.Google Scholar
  49. 49.
    Bertakis KD: The communication of information from physician to patient: A method for increasing patient retention and satisfaction. J Fam Pract 5: 217–222, 1977.PubMedGoogle Scholar
  50. 50.
    Zola IK: Structural constraints in the doctor-patient relationship: The case of non-compliance. In: Eisenberg L, Kleinman A (eds.) The Relevance of Social Science for Medicine. Dordrecht, D Reidel, 1980, pp. 241–252.Google Scholar
  51. 51.
    Rogers CR: On Becoming a Person. Boston, Houghton, Mifflin, 1961.Google Scholar
  52. 52.
    Ekman P, Friesen WV: Nonverbal leakage and clues to deception. Psychiatry 32: 88–106, 1969.PubMedGoogle Scholar
  53. 53.
    DiMatteo MR, Taranta A, Friedman HS, Prince LM: Predicting patient satisfaction from physicians’ nonverbal communication skills. Med Care 18: 376–387, 1980.PubMedCrossRefGoogle Scholar
  54. 54.
    Byrne PS, Heath CC: Practitioners’ use of non-verbal behaviour in real consultations. J Roy Coll Gen Pract 30: 327–331, 1980.Google Scholar
  55. 55.
    Salzman C, Shader R, Scott DA, Binstock W: Interviewer anger and patient dropout in a walk-in clinic. Compr Psychiat 11: 267–273, 1970.PubMedCrossRefGoogle Scholar
  56. 56.
    Smith CK, Polis E, Hadac RR: Characteristics of the initial medical interview associated with patient satisfaction and understanding. J Fam Pract 12: 283–288, 1981.PubMedGoogle Scholar
  57. 57.
    Larsen K, Smith CK: Assessment of nonverbal communication in the patient-physician interview. J Fam Pract 12: 481–488, 1981.PubMedGoogle Scholar
  58. 58.
    Milmoe S, Rosenthal R, Blane HT, Chafetz ML, Wolf I: The doctor’s voice: Postdictor of successful referral of alcoholic patients. J Abn Psychol 72: 78–82, 1967.CrossRefGoogle Scholar
  59. 59.
    Duncan DS, Rosenthal R: Vocal emphasis in experimenters’ introduction reading as unintended determinant of subjects’ responses. Language & Speech 11: 20–26, 1968.Google Scholar
  60. 60.
    LaCrosse MB: Nonverbal behavior and perceived counselor attractiveness and pursuasiveness. J Counsel Psychol 22: 563–566, 1975.CrossRefGoogle Scholar
  61. 61.
    Svarstad BL: Physician-patient communication and patient conformity with medical advice. In: Mechanic D (ed.) The Growth of Bureaucratic Medicine: An Inquiry into the Dynamics of Patient Behavior and the Organization of Medical Care. New York, Wiley, 1976, pp. 220–238.Google Scholar
  62. 62.
    Taylor RB: The Practical Art of Medicine. Hagerstown, Harper & Row, 1972.Google Scholar
  63. 63.
    Brody H, Waters DB: Diagnosis is treatment. J Fam Pract 10: 445–449, 1980.PubMedGoogle Scholar
  64. 64.
    Ketai R: Family practitioners’ knowledge about treatment of depression. JAMA 235: 2600–2603, 1976.PubMedCrossRefGoogle Scholar
  65. 65.
    Ben-Sira Z: Affective and instrumental components in the physician-patient relationship: An additional di-mention of interactional theory. J Health Soc Behav 21: 170–180, 1980.PubMedCrossRefGoogle Scholar
  66. 66.
    Leik R, Leik S: Transition to interpersonal commitment. In: Hamblin R, Kunkel J (eds.) Behavioral Theory in Sociology. Transaction, 1977, pp. 299–322.Google Scholar
  67. 67.
    Hornsby JL, Payne FE Jr.: A model for communication skills development for family practice residents. J Fam Pract 8: 71–76, 1979.PubMedGoogle Scholar
  68. 68.
    Fine VK, Therrin ME: Empathy in the doctor-patient relationship: Skill training for medical students. J Med Educ 52: 752–757, 1977.PubMedGoogle Scholar
  69. 69.
    Haase RF, Tepper DT: Nonverbal components of empathic communication. J Counsel Psychol 19: 417–424, 1972.CrossRefGoogle Scholar
  70. 70.
    Ward NG, Stein L: Reducing emotional distance: A new method to teach interviewing skills. J Med Educ 50: 605–614, 1975.PubMedGoogle Scholar
  71. 71.
    Gilbert S, Horenstein D: The dyadic effects of self-disclosure: Level versus valence. Hum Commun Res 1: 316–322, 1975.CrossRefGoogle Scholar
  72. 72.
    Lochman JE, Dain RN, Fogleman JD, Sullivan DH: Interviewing skills training in a family practice residency program. J Fam Pract 12: 1080–1081, 1981.PubMedGoogle Scholar
  73. 73.
    Kahana RJ, Bibring GL: Personality types in medical management. In: Zinberg NE (ed.) Psychiatry and Medical Practice in a General Hospital. New York, International Universities Press, 1964, pp. 108–123.Google Scholar
  74. 74.
    Issacs KS, Haggard EA: Some methods used in the study of affect in psychotherapy. In: Gottschalk LA, Auerbach AH (eds.) Methods of Research in Psychotherapy. New York, Appleton-Century-Crofts, 1966, pp. 234–238.Google Scholar
  75. 75.
    Kleinman A, Eisenberg L, Good B: Culture, illness and care: Clinical lessons from anthropologic and cross-cultural research. Ann Intern Med 88: 251–258, 1978.PubMedCrossRefGoogle Scholar
  76. 76.
    Reading A: Illness and disease. Med Clin North Am 61: 703–710, 1977.PubMedGoogle Scholar
  77. 77.
    McWhinney IR: Beyond diagnosis: An approach to the integration of behavioral science and clinical medicine. N Engl J Med 287: 384–387, 1972.PubMedCrossRefGoogle Scholar
  78. 78.
    Eisenberg L: What makes persons “patients” and patients “well.” Am J Med 69: 277–286, 1980.PubMedCrossRefGoogle Scholar
  79. 79.
    Chrisman NJ, Baker RM: Exploring the doctor-patient relationship: A sociocultural pilot study in a family practice residency. J Fam Pract 7: 713–719, 1978.PubMedGoogle Scholar
  80. 80.
    Zola IK: Pathways to the doctor: From person to patient. Soc Sci Med 7: 677–689, 1973.PubMedCrossRefGoogle Scholar
  81. 81.
    Lipowski ZJ: Physical illness, the individual, and the coping process. Psychiatry in Med 1: 91–102, 1970.CrossRefGoogle Scholar
  82. 82.
    Engel GL: The clinical application of the biopsychosocial model. Am J Psychiatry 137: 535–544, 1980.PubMedGoogle Scholar
  83. 83.
    Engel GL: The need for a new medical model: A challenge for biomedicine. Science 196: 129–136, 1977.PubMedCrossRefGoogle Scholar
  84. 84.
    Engel GL: The biopsychosocial model and the education of health professionals. Ann N Y Acad Sci 310: 169–181, 1978.PubMedCrossRefGoogle Scholar
  85. 85.
    Pfifferling JH: A cultural prescription for medicocentrism. In: Eisenberg L, Kleinman A (eds.) The relevance of social science for medicine. Dordrecht, Holland, D Reidel, 1980, pp. 197–222.Google Scholar
  86. 86.
    Katon W, Kleinman A: Doctor-patient negotiation and other social science strategies in patient care. In: Eisenberg L, Kleinman A (eds.) The Relevance of Social Science for Medicine. Dordrecht, Holland, D Reidel, 1980, pp. 253–282.Google Scholar
  87. 87.
    Blumhagen D: Hyper-tension: A folk illness with a medical name. Cult Med Psychiatry 4: 197–227, 1980.PubMedCrossRefGoogle Scholar
  88. 88.
    Good BJ, Good MD: The meaning of symptoms: A cultural hermeneutic model for clinical practice. In: Eisenberg L, Kleinman A (eds.) The Relevance of Social Science for Medicine. Dordrecht, Holland, D Rei-del, 1980, pp. 165–196.Google Scholar
  89. 89.
    Platt FW, McMath JC: Clinical hypocompetence: The interview. Ann Intern Med 91: 898–902, 1979.PubMedCrossRefGoogle Scholar
  90. 90.
    Kepecs JG: Tracking errors in psychotherapy. Am J Psychother 33: 365–377, 1979.PubMedGoogle Scholar
  91. 91.
    Groves JE: Taking care of the hateful patient. N Engl J Med 298: 883–887, 1978.PubMedCrossRefGoogle Scholar
  92. 92.
    Anstett R: The difficult patient and the physician-patient relationship. J Fam Pract 11: 281–286, 1980.PubMedGoogle Scholar
  93. 93.
    Ries RK, Bokan JA, Katon WJ, Kleinman A: The medical care abuser: Differential diagnosis and management. J Fam Pract 13: 257–265, 1981.PubMedGoogle Scholar
  94. 94.
    Taylor SE: Hospital patient behavior: Reactance, helplessness, or control? J Soc Issues 35: 156–184, 1979.CrossRefGoogle Scholar
  95. 95.
    Kris K: Psychiatric consultation in the management of patient ambivalence interfering with the doctor-patient relationship. AmJ Psychiatry 138: 194–197, 1981.Google Scholar
  96. 96.
    Papper S: The undesirable patient. J Chron Dis 22: 777–779, 1970.PubMedCrossRefGoogle Scholar
  97. 97.
    Berger LR: The Winnicott squiggle game: A vehicle for communicating with the school aged child. Pediatrics 66: 921–924, 1980.PubMedGoogle Scholar
  98. 98.
    Andolsek K, Novik B: Use of hypnosis with children. J Fam Pract 10: 503–507, 1980.PubMedGoogle Scholar
  99. 99.
    Sanders JH Jr: The etiquette of primary care. Primary Care 7: 529–544, 1980.PubMedGoogle Scholar
  100. 100.
    Haug M: Doctor patient relationships and the older patient. J Gerontol 34: 852–860, 1979.PubMedCrossRefGoogle Scholar
  101. 101.
    Scher M, Wilson L, Mason J: The management of chronic schizophrenia. J Fam Pract 11: 407–413, 1980.PubMedGoogle Scholar
  102. 102.
    Westbury RC: The electric speaking practice: A telephone workload study. Can Fam Phys 20: 69, 1974.Google Scholar
  103. 103.
    Greitzer L, Stapleton FB, Wright L, Wedgewood RJ: Telephone assessment of illness by practicing pediatricians. J Pediatr 88: 880–882, 1976.PubMedCrossRefGoogle Scholar
  104. 104.
    Perrin EC, Goodman HC: Telephone management of acute pediatric illness. N Engl J Med 298: 130–135, 1978.PubMedCrossRefGoogle Scholar
  105. 105.
    Ott JE, Bellaire J, Machotka P, Moon JB: Patient management by telephone by child health associates and pediatric house officers. J Med Educ 49: 596–600, 1974.PubMedGoogle Scholar
  106. 106.
    Conrath VW, Buckingham P, Dunn EV, et al: An experimental evaluation of alternative communication systems as used for medical diagnosis. Behav Sci 20: 296–305, 1975.PubMedCrossRefGoogle Scholar
  107. 107.
    Spitz L, Bloch E: Denial and minimization in telephone contacts with patients. J Fam Pract 12: 93–98, 1981.PubMedGoogle Scholar
  108. 108.
    Strasser PH, Levy JC, Lamb GA, Rosenkrans J: Controlled clinical trial of pediatric telephone protocols. Pediatrics 64: 553–557, 1979.PubMedGoogle Scholar
  109. 109.
    Levy JC, Rosenkrans J, Lamb GA, Friedman M, Kaplan D, Strasser P: Development and field testing of protocols for the management of pediatric telephone calls: Protocols for pediatric telephone calls. Pediatrics 64: 558–563, 1979.PubMedGoogle Scholar
  110. 110.
    Boekelheide PD: Termination and transfer of patients in family practice. J Fam Pract 6: 1019–1024, 1978.PubMedGoogle Scholar
  111. 111.
    Scott NC, Donnelly MB, Hess JW: Changes in interviewing styles of medical students. J Med Educ 50: 1124–1126, 1975.PubMedGoogle Scholar
  112. 112.
    Balint M: The Doctor, His Patient, and the Illness. London, Pitman, 1957.Google Scholar
  113. 113.
    Scheingold L: A Balint seminar in the family practice residency setting. J Fam Pract 10: 267–270, 1980.PubMedGoogle Scholar
  114. 114.
    Anderson JL: A practical approach to teaching about communication with terminal cancer patients. J Med Educ 54: 823–824, 1979.PubMedGoogle Scholar
  115. 115.
    Siris SG, Docherty JP, Roose SP: An experience with role-playing in psychiatric education. J Med Educ 55: 787–792, 1980.Google Scholar
  116. 116.
    Falvo D: Patient perception as a tool for evaluation and feedback in family practice resident training. J Fam Pract 10: 471–474, 1980.PubMedGoogle Scholar
  117. 117.
    Anstett R: Patient discussion groups in the training of family practice residents. J Fam Pract 10: 143–144, 1980.PubMedGoogle Scholar
  118. 118.
    Goldberg DP, Steele JJ, Smith C, Spivey L: Training family doctors to recognize psychiatric illness with increased accuracy. Lancet 2: 521–523, 1980.PubMedCrossRefGoogle Scholar
  119. 119.
    Verby J, Holden P, Davis R: Peer review of consultations in primary care: The use of audiovisual recordings. Br Med J 2: 1686–1688, 1979.CrossRefGoogle Scholar
  120. 120.
    Lewis E: Counter-transference problems in hospital practice. Br J Med Psychol 52: 37–42, 1979.PubMedCrossRefGoogle Scholar
  121. 121.
    Kagan N: Interpersonal Process Recall: A method for influencing human interaction. Lancing:n.p., 1976.Google Scholar
  122. 122.
    Adler LM, Enelow AJ: An instrument to measure skill in diagnostic interviewing: A teaching and evaluation tool. J Med Educ 41: 281–288, 1966.PubMedGoogle Scholar
  123. 123.
    Linn LS, Wilson RM: Factors related to a communication style among medical house staff. Med Care 18: 1013–1019, 1980.PubMedCrossRefGoogle Scholar
  124. 124.
    Carroll JG, Monroe J: Teaching medical interviewing: A critique of educational research and practice. J Med Educ 54: 498–500, 1979.PubMedGoogle Scholar

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© Springer Science+Business Media New York 1983

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  • Wayne T. Dodge

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