Communication in Healthcare
I’ve been interested in language and linguistics since I was a teenager, probably stemming from a trip to Europe when I was fourteen and seeing how words in different languages were similar to and different from each other. I’ve also purchased and read too many books on the history and evolution of the English language. Mix that with a knack for writing nonfiction in English, and later entering medical profession, and now you have another one of those how-do-I-combine-my-interests moments that seem to pepper my life.
Communication in Healthcare was one of the offered introductory courses (subjects) that supported my decision to enroll in the Australian National University’s (ANU) Master of Culture, Health and Medicine program. It is taught by university faculty from the Institute for Communication in Healthcare (ICH) and the School of Literature, Languages and Linguistics (SLLL) within the College of Arts and Social Sciences. Unfortunately I had to wait till my last semester at ANU to enroll in it because it was only being offered every other year at that time. I have to admit this was the bright spot of my weekly class schedule during that semester, even when we had to switch from in-person to online classes mid-semester because of the pandemic.
Logically, my first encounter with communication focused on how physicians communicate with patients. We really didn’t have a dedicated subject dealing with this in medical school, but some of the principles of communicating with patients (and the patient-centered approach to patient care) were incorporated in subjects like Introduction to Patient Care, Perceptions and Values in Medicine and our rotation in Family Medicine. At least that’s what I remember. Introduction to Patient Care and Perceptions and Values in Medicine were “soft” subjects – the type of courses that played second fiddle to the heavyweights like Pharmacology or Microbiology.
Within our clinical rotations, we also learned the language of the clinical chart note and clinical presentations – yes these are in English, but styled in a certain way that makes it different from conversational english or general reading material. Here is an additional linguistic layer: the “business” of clinical medicine is conducted in English, while the actual clinician-patient encounters may or may not be in English; often they are in the vernacular (Filipino or Tagalog, in the case of the Philippine General Hospital in Manila). Code switching is the formal linguistic term for this alternation between languages, and this blog post from the Oxford English Dictionary eloquently explains how Filipinos do this on an everyday basis. But I digress. Some of our rotations, such as Community Medicine, required us to produce patient-friendly educational materials which piqued my interest in bringing medical concepts to a level at which the layperson could understand. I actually enjoyed doing stuff like that, along with doing the design and lay-out for brochures, cards and the like.
Going back to the Communication in Healthcare course: I learned that linguistics went beyond communication among physicians and other healthcare professionals and physician-patient communication. Sure, effective communication within the healthcare team and with patients was of utmost importance; most of our semester was devoted to studying what aspects make communication effective and how good patient-centered communication can lead to better patient safety – reducing errors, improving clinical decision-making, ensuring improved patient adherence or compliance to the treatment plan.
But communication in healthcare also addresses how messages are delivered to the general public and how they are received. Population (or public) health relies on effective communication by government and/or non-governmental organizations with regard to health information and education. If the general public understands what is being asked of them, and why certain health measures are being implemented, they are more likely to stick to these healthy behaviors.
Complementary to effective communication is health literacy, defined as the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others. An understanding of concepts related to health and navigating the health system are also important in reducing disease and improving overall health and well-being.
Finally, a note about inter-cultural communication, which was the last topic tackled during the course. This was interesting to me as someone studying medical anthropology and also someone who has practiced medicine in multicultural societies. “Lost in translation” moments between clinicians and patients are the only the tip of the iceberg; one also has to be aware of and consider the patient’s cultural norms with regard to their perspectives on health, family dynamics and cultural taboos among other things.
All in all, I enjoyed learning from both teachers and classmates in the Communication in Healthcare course. As the teachers were linguists, the material was taught from their perspective – this complemented my clinical education and experience very well. The course was also useful and practical for non-clinicians and non-linguists as the teachers made sure that the educational material and the approach was accessible to students of all disciplines. I would highly recommend this course to anyone interested and also send a special shout out to Professor Diana Slade and Dr. Mary Dahm, who with Dr. Suzanne Eggins expertly guided our class through the semester.
