包括的なタスクは、グラスゴー合意声明における教育と実践を変えることができるか？

Modern healthcare is rapidly changing: there is increased specialization, fragmentation, and digitalization. Patients are likely to meet many providers in different roles and professions in a disease trajectory, and encounters may often be brief and focused on specific problems to be solved. This paper builds on these observations described in the Glasgow Consensus Statement. Existing communication models are designed for the typical general doctor-patient consultations of the past, while healthcare includes a wide variety of situations and tasks. The models do not sufficiently account for important barriers in professional communication. These include lack of acknowledgment of the survival function of communication, the habit of making assumptions, and effects of cognitive overload, uncertainty, vulnerability, and the power asymmetry. We present how we think a focus on three overarching tasks, relevant in all encounters, may help cognitively overloaded clinicians to create an atmosphere of connection and trust both in short and complex conversations. The clinical examples are related to musculoskeletal pain.