Problems in Physician-Patient Communication: What do our Students See and Hear? A Qualitative Study with a Pragmatic Approach

Background: Efficient communication with patients is an indispensable necessity for physicians of the 21st century. Over the past decades, much work has been done nationally and internationally to instill this essential skill in undergraduate students and medical graduates are now formally trained to become better communicators. However, deficiencies persist and medical students of today still observe various issues when they observe physician-patient communication interactions in their training.

Objective: To understand perceptions of undergraduate medical students about the difficulties in Physician-Patient communication (PPC) & take suggestions on how to overcome them.

Methods: A qualitative study design was employed, with data collection through three focus group discussions with medical students studying in Wah medical college, Pakistan in October 2019. Thematic data analysis was done using Atlas-ti 8 software. A pragmatic approach was used to understand student perceptions about difficulties in PPC.

Results: After open and selective coding of data, six major themes were identified. Five of these were in relation to students' perceptions about major difficulties with PPC. These included gap between teaching & practice; doctor patient ratio; lack of counselling; lack of empathy and no informational care. The last theme, Effective teaching of behavioral sciences was related to student suggestions for overcoming problems in PPC.

Conclusion: The various issues regarding the problems in physician patient communication portray a realistic picture of our current communication practices. Various factors have been identified in this study and, the most practical solution to these problems lies in the effective teaching of behavioral sciences.