Spot light shines on patient-physician communication

The house lights dimmed, save for a single spot trained on an elevated desk and chair. On the desktop rested a telephone, an address book, and several prescription pill containers. A slender female figure clad in a bathrobe emerged from behind a screen and made her way, painfully and hesitantly, to the chair and desk. After an agonising effort to open the pill containers ---which sent the contents scattering to the floor--- the young woman made a desperate phone call to her rheumatologist. Initially rebuffed by the answering receptionist, she made a second phone call, this time connecting with the physician. Out tumbled her grief, her pain, her fear at losing control of her life, her job, her marriage and her other essential relationships. Sadly, her cries for help hit a blank wall of incomprehension and insensitivity at the other end of the line.

Those few dark moments of torment and terror took the audience members to an emotional place that could be termed “the-land-of-suffering-compounded-by-poor-communication-between-patients-and physicians”. The caller’s suffering and her frustration at her inability to convey her sense of fear and helplessness were intensely moving, palpable and real. Don’t all patients know that place? But do others? Do physicians? What do we do about it?

Participants were at the Canadian Rheumatology Association Annual Meeting held in Mount Tremblant, Quebec, from March 2-6 and what they had just witnessed was a piece of theatre featuring a skilled performance by an actress from the Porte Parole Documentary Theatre of Montreal. The scene described above was followed by a focussed discussion skilfully led by Dr. Monique Camerlain and a panel of educational experts on health care communication issues. We learned that 48% of Canadians have literacy problems, defined as the “ability to find, read, and understand information”. We learned that physicians, by contrast, customarily employ regulatory and abstract language that draws heavily on print and technology. We learned that communication problems are the most common root cause of medical error. In sum, we learned that a huge communication chasm still confronts health care consumer activists seeking ways to sensitise the health care system to patient needs and concerns.

But how many of us have considered harnessing the emotional power of the theatre to aid us in getting that message across? As those who witnessed the scene described will readily attest, this was one of the most riveting and effective methods of focussing attention on an important issue in contemporary health care seen in recent memory.

There is a kind of truth in the emotion of the theatrical medium that enhances the impact of primary messages in a uniquely powerful way. You may wish to consider whether its techniques might have application to your own efforts in advocacy.