Skills and effort are key

Papers p 679 Clinical review p 697

Anyone who wants to be regarded as a good doctor needs to possess effective communication skills. Everyone expects that of us, but the truth is that good communication is often quite difficult and training for it is still developing.

Communication skills make an appreciable difference to clinical management. We take for granted our own communication abilities in history taking, but further training can enhance our ability to diagnose and treat conditions, including depression.1 Communication is often a major component of the medical management in chronic and palliative care: sometimes it is all we have to offer. Compared with most medications, communication skills have undoubted palliative efficacy (often reducing symptoms significantly), a wide therapeutic index (overdose is rare), and the commonest problem in practice is suboptimal dosing. At a more mercenary level, poor communication skills have been shown to be a predictor of medicolegal vulnerability and …