Do we hear our patients? And would a patient's page help?

Today I spoke at a medical education meeting about a communication skills course I have been piloting for our senior house officers. Attendance has been patchy and poor. I wondered if the consultants were really supportive about releasing them from duties to attend the course. I tried to explain the importance of integrating both informative and receptive behaviours in the medical interview. Everybody knows that we need to give information accurately in ways that patients can understand. But how can you explain succinctly the importance of the receptive behaviours—that is, understanding what the patient and relatives are really concerned about …

My recurring nightmare last night was particularly vivid. Geoff, my partner, was lying in his hospital bed. But was it really him and was he alive or dead? The horror increased as Dr Harold Shipman came into the picture. How or why I don't know. It was a relief to wake up. The Shipman element must represent my continuing anger …