Communication Tips

1) Exude confidence

If you want people to take you seriously and consider your recommendations, you need to act confident. “Wishy-washy” and indecisive people do not get respect from the team and their recommendations are usually ignored. Why is that? If you are the physician, you want to know for certain that you are doing the best for the patient’s interest. You want to trust the person who is supposed to advise you. The patient’s life is at stake as well as their liability.

2) Research your answer

No one expects you to know everything about drugs or all about the latest clinical trials. It is perfectly acceptable to research your answers before communicating it to the team. You should have plenty of evidence and supporting data readily available, in case they want to see it. Be precise. Do not guess or speculate your answer.

3) SOAP your recommendations

Remember learning about SOAP? SOAP-ing is a common practice of physicians to communicate patient’s problems to the medical team. Each patient problem is broken down by the 4 letters: S for symptoms, O for objective data, A for assessment, and P for the plan. For example, for a patient’s complicated UTI, you would see:

Problem #1: Complicated UTI

S- Fever of 102.5, lower back pain, pain upon urination

O- UA shows positive nitrites, leukocytes, and moderate bacteria. Culture is pending. BS is 200-250. HgA1c 9.4%.

A- Pt has complicated UTI, with uncontrolled DM type 2.

P- Start Levaquin 500 mg IV Q24H x 7 days. Monitor culture/sensitivity. Manage BS with intensive insulin regimen (see problem #2- uncontrolled DM type 2).

If physicians think and write in this format, then they are more likely to comprehend recommendations in the same fashion. See the following examples for oral or written communication.

Verbal recommendation

Greeting: Hello Dr_____

Identify the patient: I would like to talk about Mr/Ms.____ in ICU/ER/tele/etc. about their antibiotics.

(Pause to let the physician remember the patient)

(O- objective data)This patient is on Levaquin 500 mg IV Q24H x 3 days.

(A- assessment) Urine culture returned with Klebsiella Pneumoniae with sensitivity to Zosyn but resistant to all ABX including Levaquin.

(P- plan) Will you consider stopping Levaquin and starting Zosyn 3.375 g IV Q6H?

Written recommendation

Dear Dr______,

This 48-yo patient in Room 254 is on Levaquin 500 mg IV Q24H x 3 days (since 12/24). Urine culture (12/24) is positive with Klebsiella P. with sensitivity to Zosyn but resistant to all ABX including Levaquin. Will you consider stopping Levaquin and starting Zosyn 3.375gm IV Q6H?

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