A commitment to developing physician-patient communication skills has earned the American Academy of Orthopaedic Surgeons (AAOS) the 2003 IHC (formerly, the Bayer Institute for Health Care Communication) Partner Award.
The AAOS received the award for its innovative Communication Skills Mentoring Program, a three-year pilot project designed to train orthopaedic surgeons in a new model for communicating with patients.
The AAOS is the first medical specialty association to develop a comprehensive national communication program of this type, demonstrating valuable leadership and foresight.
Improve Communication Skills
Recent research conducted by the AAOS suggested that patients perceived orthopaedic surgeons as “high tech, low touch.” In other words, while patients gave these physicians high marks for their skills in the operating room, the same was not true when it came to listening and communicating.
The research findings coincided with changes occurring in residency training and recertification programs. The most notable of these was in the U.S. Medical Licensing Examination (used for granting a physician his or her initial license to practice medicine). In 2004, a clinical skills exam will measure prospective physicians’ communication and diagnostic skills.
At the same time, other medical specialties added “physician-patient communication skills” to their training curricula because of strong evidence that effective skills in this arena improve health outcomes for patients — and reduce the risk of malpractice suits for physicians.
A Comprehensive Curriculum
As the leading provider of Continuing Medical Education (CME) for orthopaedic surgeons, the AAOS believed that offering a standard training curriculum for effective physician-patient communication skills would be highly beneficial for its members, orthopaedic surgeons-in-training and patients. The Academy felt that the most effective curriculum would involve experienced surgeons acting as mentors and trainers.
To develop the most effective curriculum possible, the AAOS approved a three-year pilot program. A total of 24 orthopaedic surgeons were trained as mentors. Each taught four interactive 4-1/2 hour workshops and ultimately, more than 1600 orthopaedic surgeons would be trained in the new model for communicating with patients.
The AAOS proposed that if successful, the communication workshop would become a permanent offering in the extensive AAOS continuing medical education program.
An Experienced Partner
Before the AAOS implemented the pilot program, however, the Academy sought a partner with an existing and effective physician communication curriculum that could be adapted to the specific experience of orthopaedic surgeons. They found that partner: The Institute for Healthcare Communication (IHC).
Established in 1987, IHC is a research and education organization dedicated to enhancing the quality of healthcare by improving communication between clinicians and patients. The Institute has trained more than 90,000 physician participants in a clinical model known as the “4Es” (Engage, Empathize, Educate, Enlist). The curriculum includes numerous training videos to help clinicians better understand the “4E” model – and how to apply it in the office or clinic.
By implementing the “4Es,” clinicians can improve health outcomes by increasing the likelihood that patients will adhere to a prescribed treatment regimen. IHC’s research data also suggests that effective communication skills maximize a physician’s efficiency and create greater satisfaction for both patient and clinician by improving productivity and making the time spent with patients more enjoyable.
IHC and AAOS — A Winning Combination
IHC and the AAOS created an outstanding medical training partnership. Together, the organizations produced three video case studies featuring interviews with real orthopaedic patients, moving the training program from the theoretical realm into the practical. The videos, in conjunction with other elements of the AAOS pilot program (including orthopaedic surgeon mentors, interactive workshops and IHC’s “4Es” clinical training model),instilled important communication skills – and the need for them – in the demanding, technically oriented orthopaedic surgeons.
John R. Tongue, M.D., AAOS Project Team Leader and past Chairman of the AAOS Board of Councilors, expects the Communication Skills Mentoring Program to achieve the Academy’s goals to improve orthopedic surgeons’ communication skills and enhance their reputation as physicians.
Participant evaluations have been overwhelmingly positive; participants at the first workshop (held at Oregon Health Sciences University in Portland) rated the seminar 3.7 out of 4.0. Scores have remained at that level since, and Dr. Tongue expects 100 equally successful workshops to be completed by June 30, 2004.
Insurers and others concerned with the quality of medical care are also beginning to recognize the value of communication training. Since 70% of malpractice suits arise from communication breakdowns between clinician and patient, medical insurance companies are beginning to provide incentives for physicians to become more effective communicators. Companies in six states currently offer malpractice insurance discounts to physicians who participate in CME workshops focusing on communication training. This can result in a significant savings for physicians who often pay as much as $100,000 annually for insurance. Two of these companies adopted the discount policy after seeing an AAOS workshop in action.