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Communication is a highly complicated interpersonal process of people relating to each other
through conversation, writing, gestures, appearance, behavior, and at times even silence.
Medical assistants must recognize, know, and practice proper communication techniques with
people: patients, family members, colleagues, and other professionals in a health care setting.
Communication Process in Medical Office
When two people communicate with eachother one-on-one, it is called interpersonal communication. Such
communications not only occur among medical assistants and patients, but also among medical assistants and support
personnel. Support personnel may include housekeeping, maintenance, security, supply, and food service staff.
Another critical communication interaction occurs among medical assistants and co-workers, patient family
members, and other visitors to the medical office. It is only through effective communication that
medical assistants are able to identify the goals of individual people and the healthcare system.
Because of the critical nature of communication in health care delivery, it is
important that medical assistants understand the communication process and the techniques used to promote open,
honest, and effective interactions.
The human communication process consists of four basic parts: the
sender of the message, the message, the receiver of the message, and feedback. The sender of the message starts the
process. The message is the body of information the sender wishes to transmit to the receiver. The receiver is the
individual intended to receive the message. Feedback is the response given by the receiver to the message.
Feedback, at times, is used to validate whether effective communication has taken place.
Verbal and Nonverbal Communication
The two basic modes of communication are verbal and nonverbal. Verbal
communication is either spoken or written. Verbal communication involves the use of words. Nonverbal
communication, on the other hand, does not involve the use of words. Dress, gestures, touching, body
language, face and eye behavior, and even silence are forms of nonverbal communication. Remember that even
though there are two forms of communication, both the verbal and the nonverbal are inseparable in the total
communication process. Conscious awareness of this fact is extremely important because their professional
effectiveness is highly dependent upon successful communication.
Barriers to Effective Communication
Ineffective communication occurs when obstacles or barriers are present.
These barriers are classified as physiological, physical, or psychosocial.
Physiological barriers result from some kind of sensory
dysfunction on the part of either the sender or the receiver. Such things as hearing impairments, speech
defects, and even vision problems influence the effectiveness of communication.
Physical barriers consist of elements in the environment
(such as noise) that contribute to the development of physiological barriers (such as the inability to
Psychosocial barriers are usually the result of one's
inaccurate perception of self or others; the presence of some defense mechanism employed to cope with some
form of threatening anxiety; or the existence of factors such as age, education, culture, language,
nationality, or a multitude of other socioeconomic factors. Psychological barriers are the most difficult
to identify and the most common cause of communication failure or breakdown. Medical assistants might or
might not be aware of it, but a person's true feelings are often communicated more accurately through
nonverbal communication than through verbal communication.
Listening, a critical element of the communication process, becomes the
primary activity for the medical assistant, who must use communication as a tool for collecting or giving
information. When one is engaged in listening, it is important to direct attention to both the verbal and
nonverbal cues provided by the other person. Like many other skills necessary for providing a health care
service, listening requires conscious effort and constant practice. Their listening skills can be improved
and enhanced by developing the following attitudes and skills:
Hear the speaker out
Focus on ideas
Remove or adjust distractions
Concentrate on the immediate interaction
Medical assistants will be using the communication process to service a
patient's needs, both short and long-term. To simplify this discussion, short-term needs will be discussed
under the heading of "patient contact point." Long-term needs will be discussed under the heading of
PATIENT CONTACT POINT
To give medical assistants a frame of reference for the following
discussion, the following definitions will clarify and standardize some critical terms:
1. Initial contact point - The physical location where
patients experience their first communication encounter with a person representing, in some role, the
health care facility.
2. Contact point - The place or event where the contact
point person and the patient meet. The contact point meeting can occur anywhere in a medical office or
clinic, and also includes telephone events.
3. Contact point person - The medical assistant in any
health care experience whose role and responsibility is to provide a service to the patient. The contact
point person has certain criteria to meet in establishing a good relationship with the patient. Helping
the patient through trying experiences is partially the responsibility of all contact point personnel.
Such medical assistants must not only have skills related to their professional duty, but they must also
have the ability to interact in a positive, meaningful way to communicate concern and the desire to
provide a service.
Consumers of health care services expect to be treated promptly,
courteously, and correctly. They expect their care to be personalized and communicated to them in terms
Some of the most frequent complaints received in a medical office or
clinic are those pertaining to the lack of courtesy, tact, and sympathetic regard for patients and their
families exhibited by medical office staff. These points of initial patient contact, which include central
appointment desks , telephones, patient affairs offices, emergency rooms, pharmacies, laboratories, record
offices, information desks, walk-in and specialty clinics, and hospitals are critical in conveying to the
entering patient the sense that their personnel is there to help them. The personnel who man these
critical areas are responsible for ensuring that the assistance that they provide is truly reflective of
the spirit of "caring" for which a medical office or clinic must stand.
No matter how excellent and expert the care in any of the above listed
facilities may be, an early impression of nonchalance, disregard, rudeness, or neglect of the needs of
patients reflects poorly on its efforts and achievements. Medical assistants must be constantly on their
guard to refrain from off-hand remarks or jokes in the presence of patients or their families. We must
insist that our personnel in all patient areas are professional in their attitudes. What may be
commonplace to us may be to a patient frightening or subject to misinterpretation.
By example and precept, we must insist that, in dealing with our
beneficiaries, no complaint is ever too trivial not to deserve the best response of which we are capable.
. . .
A distinguishing aspect of therapeutic communication is its application
to long-term communication interactions. Therapeutic communication is defined as the face-to-face process
of interacting that focuses on advancing the physical and emotional well-being of a patient. This kind of
communication has three general purposes:
Collecting information to determine illness
Assessing and modifying behavior
and providing health education.
By using therapeutic communication, we attempt to learn as much as we
can about the patient in relation to his illness. To accomplish this learning, both the sender and the
receiver must be consciously aware of the confidentiality of the information disclosed and received during
the communication process. Medical assistants must always have a therapeutic reason for invading a
When used to collect information, therapeutic communication requires a
great deal of sensitivity as well as expertise in using interviewing skills. To ensure the identification
and clarification of the patient's thoughts and feelings, medical assistants, as the interviewer, must
observe his behavior. Listen to the patient and watch how he listens to medical assistants. Observe how he
gives and receives both verbal and nonverbal responses. Lastly, interpret and record the data medical
assistants have observed.
As mentioned earlier, listening is one of the most difficult skills to
master. It requires medical assistants to maintain an open mind, eliminate both internal and external
noise and distractions, and channel attention to all verbal and nonverbal messages. Listening involves the
ability to recognize pitch and tone of voice, evaluate vocabulary and choice of words, and recognize
hesitancy or intensity of speech as part of the total communication attempt. The patient crying aloud for
help after a fall is communicating a need for assistance. This cry for help sounds very different from the
call for assistance medical assistants might make when requesting help in transcribing a physician's
The ability to recognize and interpret nonverbal responses depends upon
consistent development of observation skills. As medical assistants continue to mature in their role and
responsibilities as a member of the health care team, both their clinical knowledge and understanding of
human behavior will also grow. Their growth in both knowledge and understanding will contribute to their
ability to recognize and interpret many kinds of nonverbal communication. Their sensitivity in listening
with their eyes will become as refined as-if not better than-listening with their ears.
The effectiveness of an interview is influenced by both the amount of
information and the degree of motivation possessed by the patient (the person being interviewed). Factors
that enhance the quality of an interview consist of the participant's knowledge of the subject under
consideration; his patience, temperament, and listening skills; and their attention to both verbal and
nonverbal cues. Courtesy, understanding, and nonjudgmental attitudes must be mutual goals of both the
interviewee and the interviewer.
Finally, to function effectively in the communication process, medical
assistants must be informed and skilled participants in all areas of the medical office. The
development of required knowledge and skills is dependent upon their commitment to seeking out and
participating in continuing education learning experiences across the entire spectrum of medical office
and health care services.
Medical Assistant Forum:
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