BMJ  2004;328:1318 (29 May), doi:10.1136/bmj.328.7451.1318-b

Letter

Doctors' communication of trust, care, and respect

Communication needs of all kinds of people should be explored

The first 150 words of the full text of this article appear below.

EDITOR—Smith queries whether the results of the paper by Burkitt Wright et al about doctors' communication with patients with breast cancer are generalisable to other patients.^{1 2} Treatment for early breast cancer is unpleasant, but the bulk is likely to be over within a year; the patient then carries on with life as before. Many chronic diseases, however, have a variable course, making diagnosis and prognosis problematic. Patients can face ongoing uncertainty, continuing pain, and increasing, variable impairments. Doctors are experts in medicine or surgery, but if patients rely solely on doctors, they might not learn of other ways of maintaining their lifestyle.³

This study excluded patients with acute distress, cognitive impairment, or insufficient English,¹ so the opinions of people in those groups are not known—another reason why the results cannot be generalised. Doctors need to communicate with everyone, and acknowledge that they will need communication support if they . . . [Full text of this article]

Central Liverpool Primary Care Trust, Liverpool L3 6AL Joyce.Carter@centralliverpoolpct.nhs.uk

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