Benefits of Good Communication Skills

The fact that competency in communication skills is a mandate of large medical governing organizations reflects today’s emphasis on the importance of communication skills. In 2001, the Institute of Medicine declared that patient-centered care was one of six objectives for improving health care in the 21st century (IOM, 2001). In 1999, the Association of American Medical Colleges called for greater teaching of communication skills (AAMC, 1999) and followed up in 2004 by implementing communication skills assessments in the Step 2 Clinical Skills exam (NBME, 2010). In 2003, the Accreditation Council for Graduate Medical Education requested competency-based teaching and assessment of “interpersonal and communication skills” as a core clinical competency (ACGME, 2007). The American Board of Medical Specialties adopted the same competencies or re-certification (ABMS, 2016).

Good communication forms the basis of rapport, trust and professionalism (Gabay, 2015). Further, because of computers, electronic health records and the internet, better communication is more necessary than ever to obtain accurate histories and assist patients in their navigation of the health system, as well as to contain cost (Lazare, 1995; Stewart, 2011; Epstein, 2005; Wright, 2008). While communication deficiencies produce negative outcomes, improved communication results in higher satisfaction both for patients and their clinicians, and good evidence shows that it has a positive downstream effect on measurable medical outcomes.

Consider the outcomes of clinical encounters. Greater patient and clinician satisfaction, greater patient understanding and acceptance of treatment plans, reduced patient distress and fewer lawsuits are key outcomes related to communication skills. Interventions to improve clinician-patient communication can lead to improved biomedical outcomes, such as better self-management of diabetes, reduced postoperative morbidity and better coping and quality of life in cancer. Here are studies about the value of communication skills.

Increased satisfaction with care and increased trust in the clinician (Boissy, 2016; Gabay, 20015; Dwamena, 2012; Haskard, 2008; Luxford, 2015; Oliveira, 2015; Street, 2012; Rao, 2007; Lelorain, 2012; Rathert, 2013; Tulsky, 2011; Venetis, 2009; Pollak, 2016).

Improvement in subjective measures such as pain (Sarinopoulos, 2013; Kravitz, 2012; Oliveira, 2015), response to pain management modalities such as acupuncture (Street, 2012) and symptoms in chronic functional disorders (Di Palma, 2012).

Improved functional and overall health status (Kaplan, 1989) and psychologic quality of life (Sep, 2014; Trevino, 2015; Oliveira, 2015; Verheul, 2010; Robinson, 2013; Lee, 2010; Luxford, 2015; Lelorain, 2012).

Reduced suffering from cancer (Arora, 2009; Bakitas, 2009; Robinson, 2013; Tulsky, 2011; Venetis, 2009; Lelorain,2012) and at the end of life (Temel, 2010; Wright, 2008; Lautrette, 2007).

Improved self-management, perceived autonomy, activation and engagement in many settings (Zolnierek, 2009; McCabe, 2013), including blood pressure medication adherence (Schoenthaler, 2009) and HIV self-management (Flickinger, 2016).

Improved patient adherence (Gabay, 2015) with medication in chronic disease (Moral, 2015) and with treatment plans (Fuertes, 2007).

Clinicians who communicate well report higher satisfaction (Boissy, 2016) and less burnout:

Clinicians who use communication skills, such as agenda-setting for a clinical encounter (Baker 2005), motivational interviewing (Pollak, 2016) or specific communication skills for managing patients with dementia (Luxford, 2015), report increased satisfaction with their encounters and decreased frustration and burnout.

Physicians who participated in a mindful communication program experienced short-term and sustained improvements in well-being and attitudes associated with patient-centered care (Krasner, 2009). Similarly, a cohort of humanistic physicians believes that treating their patients humanistically serves to prevent burnout in themselves (Chou, 2014).

Cardiac Outcomes

Hospital readmissions due to heart failure were reduced with the use of a patient centered curriculum (Record, 2011).

Patient-centered care was associated with a lower hazard ratio of death from myocardial infarction (Meterko, 2010).

Improved communication and coordination at the system level is one of several factors that distinguishes high-performing from low-performing hospitals in terms of mortality after acute myocardial infarction (Curry 2011).

A systematic review of cardiovascular outcomes affected by clinician-patient communication includes data on reduction of 10-year risk of coronary heart disease and lower incidence of post-surgical tachyarrhythmia (Schoenthaler, 2014).


Diabetes Mellitus Outcomes

Patients of more empathic physicians had better glycemic control (Hojat, 2011).

Serum glucose levels, blood pressure, and LDL improved with patient-centered counseling (Rocco, 2011; Kelley JM, 2014).

Patients with better glycemic control and cholesterol management were more likely to report that their physicians showed them respect, and those patients were more likely to recommend their physicians to others (Francis, 2014).


Surgical Outcomes 

Patients who perceived their trauma surgeons as being more empathic had better medical outcomes after hospitalization (Steinhausen, 2014).

Postoperative delirium was reduced as a result of a perioperative psycho-educational intervention (Lee, 2013).

Smith’s Patient-Centered Interviewing (Smith, 2012) cites studies from the 1990s that report improvements in surgical recovery and postoperative outcomes with patient-centered communication.


Cancer Outcomes

Positive communication skills have a favorable impact on cancer outcomes, ranging from improved cancer screening adherence (Fox, 2009) to improved cancer survival (Temel, 2010; Mustafa, 2013).


Reduced Costs

Increased patient-centeredness is associated with reduced costs for diagnostic testing (Stewart, 2011; Epstein, 2005).

Addressing communication with family members about decisions at the end of life reduced ICU admissions and unnecessary ventilation and resuscitation efforts (Wright, 2008; Zhang, 2009).

Good communication skills are necessary for clinician satisfaction and patient satisfaction and outcomes. Contact us if you’d like a free 30-day trial subscription to DocCom.



1. Accreditation Council for Graduate Medical Education. Common program requirements. effective July 1, 2007. Accessed April 4, 2016.

2. American Board of Medical Specialties. Accessed April 4.2016.

3. Arora, Weaver KE, Clayman ML, et al. Physicians' decision-making style and psychosocial outcomes among cancer survivors. Pt Educ Couns 2009; 77: 404-12.

4. Association of American Medical Colleges. Medical School Objectives Project, Report III. Contemporary Issues in Medicine: Communication in Medicine. Washington, DC: Association of American Medical Colleges, 1999.

5. Baker L, O'Connell D, Platt F. "What else?" Setting the agenda for the clinical interview. Ann Intern Med. 2005 Nov 15;143(10):766-70.

6. Bakitas M, Lyons KD, Hegel MT, et al. Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the Project ENABLE II randomized controlled trial. JAMA. 2009 Aug 19;302(7):741-9.

7. Boissy A, Gilligan T, eds. Communication the Cleveland Clinic Way. New York: McGraw Hill; 2016.

8. Chou C, Kellom K, Shea J. Attitudes and habits of highly humanistic physicians. Acad Med. 2014 Sep;89(9):1252-8. 

9. Curry LA, Spatz E, Cherlin E, et al. What distinguishes top-performing hospitals in acute myocardial infarction mortality rates? A qualitative study. Ann Intern Med. 2011;154:384-390.

10. Dwamena F, Holmes-Rovner M, Gaulden CM, et al. Cochran Database Syst Rev. Interventions for providers to promote a patient-centred approach in clinical consultations. 2012 Dec 12.

11. Di Palma JA, Herrera JL. The Role of Effective Clinician-Patient Communication in the Management of Irritable Bowel Syndrome and Chronic Constipation. J Clin Gastroenterol 2012; 46 (9): 748-751.

12. Epstein RM, Franks P, Shields CG, et al. Patient-centered communication and diagnostic testing. Ann Fam Med. 2005 Sep-Oct;3(5):415-21.

13. Flickinger TE, Saha S, Roter D, et al. Clinician empathy is associated with differences in patient–clinician communication behaviors and higher medication self-efficacy in HIV care. Patient Educ Couns 2016; 99(2):220-6.

14. Fortin AH, Dwamena FC, Frankel RM, et al. Smith's Patient-Centered Interviewing. An Evidence-Based Method, 3rd ed. New York: McGraw-Hill Medical, 2012.

15. Fox SA, Heritage J, Stockdale SE, et al. Cancer screening adherence: Does physician–patient communication matter? Pt Educ Couns 2009; 75 (2): 178-184.

16. Francis MD, Warm E, Julian KA, et al. Determinants of patient satisfaction in internal medicine resident continuity clinics: Findings of the Educational Innovations Project Ambulatory Collaborative. J Grad Med Educ. 2014 Sep;6(3):470-7.

17. Fuertes JN, Mislowack A, Bennett J, et al.The physician-patient working alliance. Patient Educ Couns. 2007 Apr;66(1):29-36. 

18. Gabay G. Perceive control over health, communication and patient-physician trust. Patient Educ Couns 2015; 98: 1550-1557.

19. Haskard KB, Williams SL, DiMatteo MR, et al. Physician and patient communication training in primary care: Effects on participation and satisfaction. Health Psychol 2008; 27: 513-522.

20. Hojat M, Louis D, Markham FW, et al. Physicians’ empathy and clinical outcomes for diabetic patients. Acad Med 2011; 86: 359-364. 

21. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century (2001). Washington, DC. National Academy Press.

22. Kaplan SH, Greenfield S, Ware JE Jr. Assessing the effects of clinician-patient interaction on the outcomes of chronic disease. Med Care 1989; 27: S110-27.

23. Kelley JM, Kraft-Todd G, Sciapira L, et al. The influence of the patient-clinician relationship on healthcare outcomes: A systematic review and meta-analysis of randomized controlled trials. PLoS One 2014; 9 (4): e94207.

24. Krasner MS,Epstein RM, Beckman H, et al. Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA. 2009; 302(12):1284-1293.

25. Kravitz RL, Tancredi DJ, Jerant A, et al. Influence of patient coaching on analgesic treatment adjustment: secondary analysis of a randomized controlled trial. J Pain Symptom Manage 2012; 43: 874-84.

26. Lautrette A, Darmon M, Megarbane B, et al. A Communication Strategy and Brochure for Relatives of Patients Dying in the ICU. N Engl J Med 2007; 356: 469-478.

27. Lazare A, Putnam SM, Lipkin M Jr. Three functions of the medical interview. In: Lipkin M Jr,, Putnam SM, Lazare A (eds). The Medical Interview: Clinical Care, Education, and Research. New York: Springer-Verlag; 1995. pp3-19.

28. Lee YY, Lin JL. Do patient autonomy preferences matter? Linking patient-centered care to patient-physician relationships and health outcomes. Soc Sci Med. 2010 Nov;71(10):1811-8.

29. Lee J, Jung J, Noh JS, et al. Perioperative psycho-educational intervention can reduce postoperative delirium in patients after cardiac surgery: a pilot study. Int J Psychiatry Med. 2013;45(2):143-58.

30. Lelorain S, BrĂ©dart A, Dolbeault S, et al. A systematic review of the associations between empathy measures and patient outcomes in cancer care. Psycho-Oncology 2012; 21: 1255–1264.

31. Luxford K, Axam A, Hasnip F, et al. Improving clinician-carer communication for safer hospital care: a study of the 'TOP 5' strategy in patients with dementia. Int J Qual Health Care. 2015 Jun;27(3):175-82. 

32. McCabe R, Healey PGT, Priebe S. Shared understanding in psychiatrist–patient communication: Association with treatment adherence in schizophrenia. Patient Educ Couns, 2013; 93 (1): 73-79.

33. Meterko M, Wright S, Lin H, et al. Mortality among patients with acute myocardial infarction: the influences of patient-centered care and evidence-based medicine. Health Serv Res. 2010 Oct;45(5 Pt 1):1188-204.

34. Moral RR, Torres LA, Ortega LP et al. Effectiveness of motivational interviewing to improve therapeutic adherence in patients over 65 years old with chronic diseases: A cluster randomized clinical trial in primary care. Patient Educ Couns. 2015 Aug;98(8):977-83. 

35. Mustafa M, Carson-Stevens A, Gillespie D, et al. Psychological interventions for women with metastatic breast cancer. Cochrane Database Syst Rev. 2013 Jun 4;6:CD004253. 

36. National Board of Medical Examiners. : 5-6. 

37. Oliveira V, Ferreira L, Pinto Z, et al. Effectiveness of training clinicians’ communication skills on patients’ clinical outcomes: a Systematic review. J Manipulative Physiol Ther 2015; 38(8):601-16.

38. Pollak K , Nagy P, Bigger J, et al. Effect of teaching motivational interviewing via communication coaching on clinician and patient satisfaction in primary care and pediatric obesity-focused offices. Pt Educ Couns, 2016 Feb;99(2):300-3. 

39. Rao J, Anderson L, Inui T, et al. Communication interventions make a difference in conversations between physicians and patients: a systematic review of the evidence. Med Care. 2007 Apr;45(4):340-9.

40. Rathert C, Wyrwich MD, Boren SA. Patient-centered care and outcomes: a systematic review of the literature. Med Care Res Rev. 2013 Aug;70(4):351-79. 

41. Record JD, Rand C, Christmas C, et al. Reducing heart failure readmissions by teaching patient-centered care to internal medicine residents. Arch Intern Med. 2011 May 9;171(9):858-9.

42. Robinson JD et al. Consultations between patients with breast cancer and surgeons: a pathway from patient-centered communication to reduced hopelessness. J Clin Oncol 2013; 31: 351-8.

43. Rocco N, Scher K, Basberg B, et al. Patient-centered plan-of-care tool for improving clinical outcomes. Qual Manag Health Care. 2011 Apr-Jun;20(2):89-97. 

44. Sarinopoulos I, Hesson AM, Gordon C, et al. Patient-centered interviewing is associated with decreased responses to painful stimuli: an initial fMRI study. Patient Educ Couns. 2013 Feb;90(2):220-5. 

45. Sep MS, van Osch M, van Vliet LM, et al. The power of clinicians' affective communication: how reassurance about non-abandonment can reduce patients' physiological arousal and increase information recall in bad news consultations. An experimental study using analogue patients. Pt Educ Couns. 2014 Apr;95(1):45-52.

46. Schoenthaler A, Kalet A, Nicholson J, et al. Does improving patient-practitioner communication improve clinical outcomes in patients with cardiovascular diseases? A systematic review of the evidence. Pt Educ Couns. 2014 Jul;96(1):3-12.

47. Schoenthaler A, Chaplin WF, Allegrante JP, et al. Provider communication effects medication adherence in hypertensive African Americans. Pt Educ Couns, 2009; 75 (2):185-191.

48. Smith A, Juraskova I, Butow P, et al. Sharing vs caring: the relative impact of sharing decisions versus managing emotions on patient outcomes. Pt Educ Couns 2011; 82: 233-9.

49. Steinhausen S, Ommen O, Antoine SL, et al. .Short- and long-term subjective medical treatment outcome of trauma surgery patients: the importance of physician empathy. Patient Prefer Adherence. 2014 Sep 18;8:1239-53. 

50. Stewart M, Ryan BL, Bodea C. Is patient-centred care associated with lower diagnostic costs? Healthc Policy. 2011 May;6(4):27-31.

51. Street Jr RL, Cox V, Kallen MA, et al. Exploring communication pathways to better health: clinician communication of expectations for acupuncture effectiveness. Patient Educ Couns 2012; 89: 245-51.

52. Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer.N Engl J Med. 2010 Aug 19;363(8):733-42.

53. Trevino KM, Maciejewski PK, Epstein AS, et al. The lasting impact of the therapeutic alliance: Patient-oncologist alliance as a predictor of caregiver bereavement adjustment. Cancer. 2015 Oct 1;121(19):3534-42. 

54. Tulsky JA , Arnold RM, Alexander SC, et al. Enhancing Communication Between Oncologists and Patients With a Computer-Based Training Program: A Randomized Trial. Ann Intern Med. 2011;155:593-601.

55. Venetis MK, Robinson JD, LaPlant K et al. An evidence base for patient-centered cancer care: A meta-analysis of studies of observed communication between cancer specialists and their patients. Pt Educ Couns 2009; 77 (3): 379-383.

56. Verheul W, Sanders A, Bensing J. The effects of physicians’ affect-oriented communication style and raising expectations on analogue patients’ anxiety, affect and expectancies Pt Educ Couns 2010; 80 ( 3): 300-306.

57. Wright AA, Zhang B, Ray A, et al. Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA. 2008;300(14):1665-1673.

58. Zhang B, Wright AA, Huskamp HA, et al. Health care costs in the last week of life: associations with end-of-life conversations. Arch Intern Med. 2009 Mar 9;169(5):480-8.

59. Zolnierek KB et al. Physician communication and patient adherence to treatment: a meta-analysis. Med Care 2009; 47: 826-34.