Dissecting clinical communication

Communication in surgical practice. White SJ, Cartmill JA, editors. Equinox Publishing, 2016 (£85.00; 410 pp). ISBN 9781781790502

I enjoyed reading Communication in surgical practice and found its focus interesting. Combining the talents of linguist health researcher Sarah White, who is a Senior Lecturer at the Faculty of Medicine and Health Sciences at Macquarie University, Sydney, and surgeon scientist John Cartmill, Associate Dean and Professor of Surgery at the Faculty of Medicine and Health Sciences at Macquarie University, this book is a methodological analysis of the non-technical elements of surgical practice in terms of the communication of the consultation, the operating theatre and the aftermath.

Communication in surgical practice will be of most interest to surgical educators. Analysing the surgical consultations and understanding them will allow for reflection and improvement — especially the insights into the discussion of language paucity of non-native English speaking doctors, who form such a large part of our health workforce.

The rational and irrational elements of surgical decision making are well summarised in chapter 4, including the significant effect of uncertainty on patient satisfaction in the case of female physicians and male patients. This chapter would serve well in all surgical education courses.

Communicating effectively and being mindful of all the elements of informed consent and shared decision making are also nicely covered in this book. We rarely get the time to break down the elements of our everyday conversations with patients, yet the revelations and insights into and about interpersonal strategies provided in the book may enlighten even the most experienced surgeon. Understanding the different ways we present information to patients, the biases potentially intrinsic in operative versus non-operative options and the elements of truly informing the patient and undertaking shared decision making can only make you a better surgeon, more appreciated by your patients and, consequently, less prone to criticism.

The final chapters of the book deal with the dynamics of the operating theatre — in all their layers — as we aim for collaboration, often requiring complex coordination, which means that words and actions can have consequences. How we speak to each other (and sometimes do not speak) and how we stand in the operating theatre and align our bodies are important factors and a matter for reflection (skilfully dissected in the book).

Communication in surgical practice enhances the education on clinical communication of both future surgeons and practising physicians.