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Healthy communication: Professor works to improve doctor/patient interactions By Kerry A. Newman
Dr. Jeffrey D. Robinson, assistant professor of speech communication at Penn State, strives to improve communication between doctors and their patients by studying their interactions, providing consultation to physicians and delivering professional development workshops to health care providers. Dave Shelly—Penn State Image Resource Center	Speech communication is a discipline that touches society in many ways other than public speaking. At Penn State, faculty members are engaged in research and activities that use communication to improve medical practice and the health of the public.   Dr. Jeffrey D. Robinson, assistant professor of speech communication, is one faculty member who is working to help health care professionals improve their communication with patients. He applied his expertise during a workshop titled “Patient/Clinician Communication” at the Issues in College Health conference, an annual education program for clinicians from the Penn State University Health Services staff. He was chosen to participate in the program because of his extensive background in working with physicians and researching their communication with patients.   Robinson designed and led the workshop, which focused on improving communication between clinicians and their patients. The goal of the session was to make the practitioners more aware of the significance of their interactions with their patients and help them increase the effectiveness of their communication. During the hour-long session, he shared with the group information about basic patterns of communication and recent research findings and trends.   “One of the trends has to do with issues of patient initiative in the interaction,” he said. “Patients very often do not ask questions. Several studies have shown that patients ask less than 1 percent of the questions.”   The workshop also included a role-playing activity designed to get the participants to practice communicating under different scenarios. Using hypothetical real-life scenarios, participants paired off and acted out how they would handle situations, using some of the techniques and ideas Robinson covered.   According to Robinson, training health care providers can have an impact on their relationships with patients and on the patients’ health.   “I want to tell the doctors that they can make a difference,” he said. “The interventions work. You can train doctors to communicate differently. You can train patients to be more active participants communicatively.”   He disclosed that some studies show that patients who ask questions about their health and engage their doctors in conversation about their health and life statistically have fewer health ailments than those patients who do not communicate well with their physicians. As a result of intervention programs, doctors can learn to better communicate with their patients and encourage them to ask more questions.   Another element of “Patient/Clinician Communication” addressed the lifestyle topics that can be difficult, or awkward, to incorporate into a conversation between doctor and patient. Some of the topics he discussed with the conference participants included diversity, age, gender, ethnicity and socioeconomic status. These topics often influence the dynamics of the interactions between physician and patient. Eating habits, tobacco use, alcohol use and weight concerns are four examples of issues that often are troublesome and hard to address during conversation. He reflected that doctors must attune themselves to the different concerns.   “One of the big problems seems to be that doctors do not know how to address these issues,” he said. “You cannot just raise topics that are off-topic. I addressed how doctors can raise issues in appropriate ways.”   The Issues in College Health conference brought together about 80 professionals from across the Penn State system to discuss relevant health and medical issues affecting University medical professionals. In addition to Robinson’s workshop, which received positive feedback from the participants, other sessions focused on the topics of asthma, alcohol use and pneumonia. The physicians, physicians’ assistants, nurse practitioners and nurses participating in the conference had the opportunity to receive continuing medical education credits for their attendance at the conference.   Robinson’s expertise in physician/patient communication stems from a background of work and research in organizational communications. His current research focuses on studying the physician/patient communication that occurs during an office visit. He works in cooperation with a local health organization to interview and observe internal medicine and family practice physicians as they interact with their patients. The research is conducted on-site within doctors’ offices by video- and audiotaping patient visits and administering questionnaires to patients both before and after the visit. After recording the data, it is carefully coded and transcribed. Typically, Robinson works with physicians within an 80-mile radius of State College, Pa. His goal is to study 40 physicians and 200 patients. Janice Krieger, a graduate assistant in the Department of Speech Communication, helps him collect and analyze the data.   In addition to his current research, he plans to pursue a study of how undergraduate students communicate with University medical personnel about tobacco and alcohol issues. He is awaiting the outcome of a grant proposal to begin his research. Teaching is also equally important to him and balances out his professional work. He instructs both undergraduate and graduate courses at Penn State. Some of the themes he addresses in his classes include communication in organizations and how cultural beliefs shape communication styles. Outside of academia, he trains physicians to help improve their patient interactions and coaches them on persuasive speaking in preparation for public presentations.   Other faculty members in the Department of Speech Communication are also engaged in outreach work with the aim of improving the public’s health. Dr. Roxanne L. Parrott, professor of speech communication, has studied public health campaigns with an emphasis on cancer prevention; Dr. Michael L. Hecht, professor of speech communication and department head, has studied adolescent drug resistance; and Dr. Jon F. Nussbaum, professor of speech communication, has studied how older adults communicate within health care delivery systems. Robinson affirmed that the work of the department crosses many disciplines, because communication is pervasive to human interactions.   “We look at a lot of different theories, a lot of different aspects of communication besides public speaking. The research we do is applicable to a lot of other walks of communication life,” he said.   While the Speech Communication faculty members work with specific populations in their research, the implications of their work are far-reaching. “To some extent,” Robinson commented, “structured language does affect how we see the world.” Accordingly, his work, and that of his peers, shows how analyzing communication patterns and messages can also improve the health of people around the world.   Just as his work focuses on improving people’s health, Robinson believes the integration of teaching, research and outreach benefits the welfare of the University.   “I am trying to make the University the type of place I think a University should be by doing outreach,” he said.