Bridging the communication gap

Dermatologists, like other doctors, now recognise the therapeutic value of an alliance with their patients (the "therapeutic alliance"), and the need to explain their advice and, as far as possible, to share management decisions with the patient. Different people may have very different values and preferences, and it is often wrong to assume agreement without explanation and discussion. Medical terms are often unfamiliar to patients. For example, to hear a rash or spot called an "eruption" or a "lesion" can be disconcerting. Using language the patient can understand, clinicians need to be able to explain the condition, its implications and treatment, as well as possible side-effects, and the consequences of not using the medication. If this can be achieved then patients are more likely to accept the requirements of the treatment and a true care partnership with the professional can be established. This could save time, and lead to quicker recovery and greater mutual trust. Unfortunately in most consultations there is not enough time to do this adequately, especially since some of the concepts that underlie diagnosis and treatment are unfamiliar to most patients and many patients lack necessary background knowledge. It is important to bridge this communication gap from both ends, by helping dermatologists and other professionals working with them to become more fluent and understanding of the patient's perspective, and by developing training and education for their current and future patients - or "consumers".

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