Communication skills for preventive interventions

Effective communication relevant to preventive services and practices has a t its basis the physician's skills in not only basic history taking and dat a collection but also relationship building, facilitation negotiation, and partnership. These skills, fundamental to doctor-patient communication, are now routinely and systematically taught in many U.S. medical schools. This article defines and examines a communication model for enhancing the provi sion and adoption of preventive practices in the primary care setting and d iscusses teaching that model in the medical school context. Within the offi ce visit, broad areas for communication tasks important to providing preven tive services are defined as: (1) the medical interview and preventive coun seling; (2) working with patients to change unhealthy behaviors, promote he althy behaviors, and enhance adherence; and (3) communication related to of fice procedures for screening and prevention. Within each of these areas, c ommunication and counseling skills and approaches are defined, and examples of associated prevention activities are provided. Methods for integrating communication skills for prevention into the medical school curriculum are discussed, and examples at Dartmouth, Brown, and MCP Hahnemann medical scho ols are presented.