I read with interest your article entitled “A Dramatic Turn” [Spring 2001] regarding the physician-patient relationship. I suspect my experience during my tenure at Yale in the early 1980s was fairly typical. I certainly received the message that truly caring about the patient as an individual was very important, but I did not receive any training regarding how to make that “caring” experience happen on any consistent basis.

This article tells me that Yale still cares very much about the patient. But I was disappointed to note its suggestion that Yale still does not know how to teach the student how to make the physician-patient relationship happen within the short appointment reality of primary care today.

I am now one of the chiefs of ophthalmology with Kaiser and The Permanente Medical Group (TPMG) in California. I have also just been recruited to be the local “communication consultant” in our facility. Communication consultants like myself are given training on the essential ingredients of an effective patient-provider interaction. These evidence-based elements have been dubbed the “Four Habits of the Highly Effective Clinician.” They form the backbone of an eight-hour curriculum which teaches the participants four key skills that allow the physician to make a satisfying human connection with the patient—even within a 15-minute interaction.

Awareness-building presentations like those of Ms. Smith’s are highly valuable. I think the next step might be offering our physicians-in-training a program similar to TPMG’s, one that teaches specific and achievable techniques to improve communication.

Ellen Kolarik, M.D. ’85
Petaluma, Calif.