Provider-Patient Partnerships. (Reviews of books, computer software, and videotapes are written by invitation).

Provider-Patient Partnerships Meldrum H, Hardy ML. Woburn, MA 01801-2041, Butterworth-Heinemann Inc, 2001, paperback, 158 pp, ISBN: 0-7506-7334-6, $21.95.

The unique feature of this book on health care communication is its presentation of real-life cases. The cases are drawn from the experiences of the authors: one is a physician, the other a professor of communication and psychology. Each case scenario is followed by a commentary that explains what happened, how the communication strategies affected the outcome, and how the communication could have been handled differently. The case scenarios are compiled into 6 categories, each forming a separate chapter--"Saying No," "Improving Adherence," "Dealing With Anger," "Bad News," "Sensitive Issues," and "Communicating About Risk."

The unique challenges to effective communication posed by managed care are addressed practically in chapter 1. Because of the constraints on fiscal resources and practitioner time imposed by managed care policies, clinicians encounter obstacles to spending the time needed to communicate effectively; therefore, it becomes more important to learn communication skills. Chapter 1 also explains how patients react to typical communication approaches and how to reframe these approaches to achieve empathy, assertiveness, and clarity.

Chapters 2 through 7 contain the case presentations described above. Chapter 2 shows how to listen to patient concerns while saying "no" when needed. Chapter 3 discusses how the use of the term "patient adherence" implies a partnership between provider and patient that the historically common term "patient compliance" does not. If patients perceive partnership in their plan of care, they will be more likely to adhere to that plan. The fourth chapter addresses how to validate patients' fears and worries in order to help diffuse their anger. Chapter 5 describes a 6-step process to use to discuss bad news with patients more empathetically. Chapter 6 discusses how to approach sensitive topics, such as sexuality, so that the provider creates a safe atmosphere for open and fruitful communication. How to communicate the potential risks involved in proposed health care interventions is presented in chapter 7. The book's final chapter, chapter 8, reviews the benefits of improving provider-patient relations, the stressors impinging on today's health care systems that affect those relationships, and a challenge to the reader to choose more effective communication practices.

Every health care practitioner faces these common communication challenges each day, making this book a useful tool for physical therapists and physical therapist assistants. It is also useful as a study guide for students and as a reference during staff meetings when communication problems arise. The weakness of the book is its lack of an in-depth explanation of communication theory. Although the suggestions on how to improve communication outcomes are excellent and are based on sound principles, the reader needs another text to supplement the case study approach of this book.

Kathryn Schaefer, PT, MPA
Physical Therapy Health Center
Arlington, Va

Ms Schaefer is in full-time private practice and is President of Physical Therapy Health Center. She lectures and writes on the topics of business management and marketing.