'What Patients Say, What Doctors Hear'

Danielle Ofri, Beacon, 242 pages, $24.95.

If you have switched physicians in search of someone more caring or left an exam feeling unseen and unheard, you will find much to appreciate in Danielle Ofri's perceptive book. The shortcomings of the patient-doctor relationship are on full display as Ofri probes what goes wrong in the exam room and tallies the impact on the care we get. Ofri makes a compelling case that patient-doctor communication in the exam room is as critical to diagnosis and treatment as expensive tests and procedures. Offering empathy, asking open-ended questions, involving the patient in a treatment plan and checking again and again to make sure patients understand are all key to making the sick better. Ofri, a physician at New York's Bellevue Hospital and a New York University professor, delves into medical research and draws on her years of practice and observation. For example, longer visits with primary-care doctors are correlated with fewer malpractice suits. Ofri's insights are particularly instructive as the medical profession increasingly suffers from tight schedules, packed waiting rooms and tightened insurance reimbursement rules. She's sensitive to her colleagues' resistance to "hokier-sounding soft stuff" such as communication, empathy and connection. But, as Ofri's compelling argument makes clear, modern medicine could benefit — down to the cost of care — from a better understanding of how humans like to be treated when they are at their most vulnerable.