The importance of developing rapport with patients cannot be overemphasized. Effective communication skills are a critical tool that assists the physician in establishing that optimal patient rapport. Physicians need to keep in mind that today's health care consumers, particularly those in the baby boomer and younger age groups, have much more medical knowledge than senior citizens. Both young and old, however, often judge the quality of care received on the basis of the physician-patient interaction. Certainly, the physician's skill and reputation play an important role in a patient's confidence. However, many if not most patients assume that physicians have the requisite technical skill to treat their medical problems. From the patient's perspective, therefore, what separates the adequate or average physician from the truly great physician is how well the physician practices the “art” of medical care, conveying those highly valued human skills of compassion and caring concern that patients seem to need so much.

All too often, when physicians do not communicate caring concern, especially when the care is painful, difficult, or results in less-than-optimal outcomes, an inevitable cycle of miscommunication occurs among patient, family, and physician. Under these circumstances, patients who express their anger and frustration may cause the physician to react defensively in a way that may be perceived as hostile or arrogant. Most often it is this response that causes the patient to seek the advice of an attorney, because poor communication between a physician and patient can lead an already angry, dissatisfied patient to believe the care was poor even when it was entirely appropriate (5). In the arena of physician liability, the burden of “successful” patient-physician communication lies with physicians (5). That is not to say that patients do not share the burden, but society and the courts have deemed that physicians have the ultimate responsibility for initiating, clarifying, facilitating, documenting, and reinforcing discussions related to their patients' condition, treatment, and prognosis (5).