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Essential Elements of Communication in Medical Encounters: The Kalamazoo Consensus Statement

Makoul, Gregory PhD

Academic Medicine:
Educating Physicians: Essays
Abstract

In May 1999, 21 leaders and representatives from major medical education and professional organizations attended an invitational conference jointly sponsored by the Bayer Institute for Health Care Communication and the Fetzer Institute. The participants focused on delineating a coherent set of essential elements in physician—patient communication to: (1) facilitate the development, implementation, and evaluation of communication-oriented curricula in medical education and (2) inform the development of specific standards in this domain. Since the group included architects and representatives of five currently used models of doctor—patient communication, participants agreed that the goals might best be achieved through review and synthesis of the models. Presentations about the five models encompassed their research base, overarching views of the medical encounter, and current applications. All attendees participated in discussion of the models and common elements. Written proceedings generated during the conference were posted on an electronic listserv for review and comment by the entire group. A three-person writing committee synthesized suggestions, resolved questions, and posted a succession of drafts on a listserv. The current document was circulated to the entire group for final approval before it was submitted for publication. The group identified seven essential sets of communication tasks: (1) build the doctor—patient relationship; (2) open the discussion; (3) gather information; (4) understand the patient's perspective; (5) share information; (6) reach agreement on problems and plans; and (7) provide closure. These broadly supported elements provide a useful framework for communication-oriented curricula and standards.

Author Information

Gregory Makoul, PhD, director of the Program in Communication and Medicine at Northwestern University Medical School, provided leadership in the writing process.

Correspondence and requests for reprints should be addressed to the Bayer Institute for Health Care Communication, 400 Morgan Lane, West Haven, CT 06516; e-mail: 〈bayer.institute@bayer.com〉.

The Bayer—Fetzer Conference on Physician—Patient Communication in Medical Education was held May 11–14, 1999. The Bayer Institute for Health Care Communication is a non-commercial, nonprofit, organization whose mission is to improve health through education, research, and advocacy in the area of clinican—patient communication. The Fetzer Institute is a nonprofit, private operating foundation that supports research, education, and service programs exploring the integral relationships among body, mind, and spirit. The conference site was Seasons, A Center for Renewal, owned and operated by the Fetzer Institute, in Kalamazoo, Michigan.

This consensus statement reflects the views of the conference participants; it does not necessarily imply endorsement by their institutions or associations.

Participants in the Bayer—Fetzer Conference on Physician—Patient Communication in Medical Education

The conference participants are listed in a box at the end of the text.

© 2001 Association of American Medical Colleges