Koyama T
Department of Psychiatry, Hokkaido University School of Medicine, Sapporo, Japan.
Hokkaido Igaku Zasshi. 1994 Sep;69(5):1081-5.
Effective interaction and communication between doctor and patient is a central clinical function that cannot be delegated. Most of the essential diagnostic information arises from the interview, and the physician's interpersonal skills also largely determine the patient's satisfaction and compliance and positively influence health outcomes. Such skills, including active listening to patient's concerns, are among the qualities of a physician most desired by patients. Increasing public dissatisfaction with the medical profession is, in good part, related to deficiencies in clinical communication. Sufficient data have now accumulated to prove that problems in doctor-patient interaction and communication are extremely common and adversely affect patient management. It has been repeatedly shown that the clinical skills needed to improve these problems can be taught and that the subsequent benefits to medical practice are demonstrable, feasible on a routine basis, and enduring. There is therefore a clear and urgent need for teaching of these clinical skills to be incorporated into medical school curriculums and continued into postgraduate training and courses in continuing medical education. If current knowledge is now implemented in clinical practice, and if the priorities for research are addressed, there may be material improvement in the relationship between patient and doctor.
医生与患者之间有效的互动和沟通是一项核心临床功能，不能委托他人进行。大部分基本诊断信息都来自问诊，医生的人际沟通技巧在很大程度上也决定了患者的满意度和依从性，并对健康结果产生积极影响。此类技巧，包括积极倾听患者的担忧，是患者最期望医生具备的素质之一。公众对医疗行业日益增加的不满情绪，很大程度上与临床沟通方面的不足有关。目前已经积累了足够的数据来证明，医患互动和沟通中的问题极为常见，并对患者管理产生不利影响。反复的研究表明，改善这些问题所需的临床技能是可以传授的，而且后续对医疗实践的益处是明显的、日常可行的且持久的。因此，迫切需要将这些临床技能的教学纳入医学院课程，并延续到研究生培训以及继续医学教育课程中。如果将当前的知识应用于临床实践，并解决研究重点问题，医患关系可能会有实质性改善。
