NOTES

Preface

  1. Stewart, J. Bridges Not Walls. A Book About Interpersonal Communication, 11th ed. New York: McGraw-Hill, 2012. (Not the Jon Stewart formerly of The Daily Show.)

  2. Lipkin Jr., M., S. M. Putnam, and A. Lazare, eds. The Medical Interview: Clinical Care, Education, and Research. New York: Springer-Verlag, 1995.

  3. Fortin, A. H. VI, R. C. Smith, F. C. Dwamena, and R. M. Frankel. Smith’s Patient-Centered Interviewing: An Evidence-Based Method, 3rd ed. New York: McGraw-Hill Professional, 2012.

  4. Details of the training can be found at http://www.ACHonline.org/Programs/Faculty-in-Training-Program. For a description of the effect of the training on 25 years of program graduates, see Chou, C. L., K. Hirschmann, A. H. Fortin VI, and P. R. Lichstein. “The Impact of a Faculty Learning Community on Professional and Personal Development: the Facilitator Training Program of the American Academy on Communication in Healthcare,” Academic Medicine 89(2014): 1051–1056.

Chapter 1

  1. Lipkin Jr., M., S. M. Putnam, and A. Lazare. “The Medical Interview: Clinical Care, Education, and Research,” New York: Springer (1995): ix.

  2. Tresolini, C. P., and the Pew–Fetzer Task Force. “Health Professions Education and Relationship–Centered Care,” San Francisco: Pew Health Professions Commission (1994).

  3. Beach, M. C., T. Inui, and the Relationship–Centered Care Research Network. “Relationship–centered Care: A Constructive Reframing,” Journal of General Internal Medicine 21 (2006): S3–8.

  4. Lown, B. A. “A Social Neuroscience–Informed Model for Teaching and Practicing Compassion in Health Care,” Medical Education 50 (2016): 332–342.

  5. Shanafelt, T. D., L. N. Dyrbye, and C. P. West. “Addressing Physician Burnout: The Way Forward,” The JAMA Network 317 (2017): 901–902.

  6. Among many others, the following is a list of representative references: Dwamena, F. et al. “Interventions for Providers to Promote a Patient–centred Approach in Clinical Consultations,” Cochran Database System Review (2012): CD003267; Gabay, G. “Perceive Control Over Health, Communication and Patient–physician Trust,” Patient Education and Counseling 98 (2015): 1550–1557; Haskard, K. B. et al. “Physician and Patient Communication Training in Primary Care: Effects on Participation and Satisfaction,” Health Psychology 27 (2008): 513–522; Pollak, K. et al. “Effect of Teaching Motivational Interviewing Via Communication Coaching on Clinician and Patient Satisfaction in Primary Care and Pediatric Obesity–focused Offices,” Patient Education and Counseling 99 (2) (2016): 300–303; Rao, J. et al. “Communication Interventions Make a Difference in Conversations Between Physicians and Patients: A Systematic Review of the Evidence,” Medical Care Apr 45 (4) (2007): 340–349; Rathert, C., M. D. Wyrwich, and S. A. Boren. “Patient–centered Care and Outcomes: A Systematic Review of the Literature,” Medical Care Research and Review August 70(4) (2013): 351–379.

  7. A representative sample of references includes: Lelorain, S. et al. “A Systematic Review of the Associations Between Empathy Measures and Patient Outcomes in Cancer Care,” Psycho–Oncology 21 (2012): 1255–1264; Luxford, K. et al. “Improving Clinician–carer Communication for Safer Hospital Care: A Study of the ‘TOP 5’ Strategy in Patients with Dementia,” International Journal for Quality Health Care June 27 (3) (2015): 175–182; Robinson, J. D. et al. “Consultations Between Patients with Breast Cancer and Surgeons: A Pathway from Patient–centered Communication to Reduced Hopelessness,” Journal of Clinical Oncology 31 (2013): 351–358; Trevino, K. M. et al. “The Lasting Impact of the Therapeutic Alliance: Patient–oncologist Alliance as a Predictor of Caregiver Bereavement Adjustment,” Cancer October 1 (121; 19) (2015): 3534–3542; Verheul, W., A. Sanders, and J. Bensing. “The Effects of Physicians’ Affect–oriented Communication Style and Raising Expectations on Analogue Patients’ Anxiety, Affect and Expectancies,” Patient Education and Counseling 80 (3)(2010): 300–306.

  8. Benner, J. S. et al. “A Novel Programme to Evaluate and Communicate 10–year Risk of CHD Reduces Predicted Risk and Improves Patients’ Modifiable Risk Factor Profile,” International Journal of Clinical Practice 62 (2008): 1484–1498.

  9. Meterko, M. et al. “Mortality Among Patients with Acute Myocardial Infarction: The Influences of Patient–centered Care and Evidence–Based Medicine,” Health Services Research Journal October 45 (5 Pt 1) (2010): 1188–1204.

10. Curry, L. A. et al. “What Distinguishes Top–Performing Hospitals in Acute Myocardial Infarction Mortality Rates? A Qualitative Study,” Annals of Internal Medicine 154 (2011): 384–390.

11. Record, J. D. et al. “Reducing Heart Failure Readmissions by Teaching Patient–centered Care to Internal Medicine Residents,” Archives of Internal Medicine Journal May 171(9) (2011): 858–859.

12. Hojat, M. et al. “Physicians’ Empathy and Clinical Outcomes for Diabetic Patients,” Academic Medicine 86 (2011): 359–364.

13. The following are representative references. For blood pressure: Schoenthaler, A. et al. “Provider Communication Effects Medication Adherence in Hypertensive African Americans,” Patient Education and Counseling 75 (2) (2009): 185–191. For diabetes: Greenfield, S. et al. “Patients’ Participation in Medical Care: Effects on Blood Sugar Control and Quality of Life in Diabetes,” Journal of General Internal Medicine 3 (1988): 448–457. For HIV: Flickinger, T. E. et al. “Clinician Empathy Is Associated with Differences in Patient–clinician Communication Behaviors and Higher Medication Self–efficacy in HIV Care,” Patient Education and Counseling 99(2) (2016): 220–226. For elderly patients with polypharmacy: Moral, R. R. et al. Collaborative Group ATEM–AP Study. “Effectiveness of Motivational Interviewing to Improve Therapeutic Adherence in Patients Over 65 Years Old with Chronic Diseases: A Cluster Randomized Clinical Trial in Primary Care,” Patient Education and Counseling August 98(8) (2015): 977–983. Weitzman, S. et al. “Improving Combined Diabetes Outcomes by Adding a Simple Patient Intervention to Physician Feedback: A Cluster Randomized Trial,” Israel Medical Association Journal 11 (2009): 719–724.

14. Di Palma, J. A., and J. L. Herrera. “The Role of Effective Clinician–Patient Communication in the Management of Irritable Bowel Syndrome and Chronic Constipation,” Journal of Clinical Gastroenterology 46(9) (2012): 748–751.

15. A couple of randomized controlled trials in primary care headed by Bob Smith demonstrate benefits in patients with medically unexplained physical symptoms, sometimes called “somatization”: Smith, R. C. et al. “Primary Care Clinicians Treat Patients with Medically Unexplained Symptoms: A Randomized Controlled Trial,” Journal of General Internal Medicine 21 (2006): 671–677; Smith, R. C. et al. “Primary Care Physicians Treat Somatization,” Journal of General Internal Medicine 24 (2009): 829–832.

16. Trummer, U. F. et al. “Does Physician–patient Communication that Aims at Empowering Patients Improve Clinical Outcome? A Case Study,” Patient Education and Counseling 61 (2006): 299–306.

17. Lee, J. et al. “Perioperative Psycho–educational Intervention Can Reduce Postoperative Delirium in Patients After Cardiac Surgery: A Pilot Study,” International Journal of Psychiatry Medicine 45(2) (2013): 143–158.

18. Steinhausen, S. et al. “Short– and Long–term Subjective Medical Treatment Outcome of Trauma Surgery Patients: The Importance of Physician Empathy,” Patient Prefer Adherence September 18(8) (2014): 1239–1253.

19. Fox, S. A. et al. “Cancer Screening Adherence: Does Physician–patient Communication Matter?,” Patient Education and Counseling 75(2) (2009): 178–184.

20. Two representative studies imply that adding psychosocial dimensions to physical and biomedical treatments improves cancer survival. One examined the interactions of palliative care clinicians who establish goals of care and assist with decision–making in addition to addressing physical symptoms (Temel, J. S. et al. “Early Palliative Care for Patients with Metastatic Non–small–cell Lung Cancer,” New England Journal of Medicine August 363(8) (2010): 733–742). The second is a Cochrane review article that found that psychological interventions improved quality of life measures and 12–month cancer survival for women with metastatic breast cancer (Mustafa, M. et al. “Psychological Interventions for Women with Metastatic Breast Cancer,” Cochrane Database of Systematic Reviews June 4(6) (2013): CD004253.)

21. Arora, N. K. et al. “Physicians’ Decision–making Style and Psychosocial Outcomes Among Cancer Survivors,” Patient Education and Counseling 77 (2009): 404–412; Bakitas, M. et al. “Effects of a Palliative Care Intervention on Clinical Outcomes in Patients with Advanced Cancer: The Project ENABLE II Randomized Controlled Trial,” The Journal of the American Medical Association August 302(7) (2009): 741–749; Lelorain, S. et al. “A Systematic Review of the Associations Between Empathy Measures and Patient Outcomes in Cancer Care,” Psycho–Oncology 21 (2012): 1255–1264; Robinson, J. D. et al. “Consultations Between Patients with Breast Cancer and Surgeons: A Pathway from Patient–centered Communication to Reduced Hopelessness,” Journal of Clinical Oncology 31 (2013): 351–358; Tulsky, J. A. et al. “Enhancing Communication Between Oncologists and Patients With a Computer–Based Training Program: A Randomized Trial,” Annals of Internal Medicine 155 (2011): 593–601; Venetis, M. K. et al. “An Evidence Base for Patient–centered Cancer Care: A Meta–analysis of Studies of Observed Communication Between Cancer Specialists and Their Patients,” Patient Education and Counseling 77(3) (2009): 379–383.

22. Temel J. S. et al., op cit.

23. Oliveira, V. C. et al. “Effectiveness of Training Clinicians’ Communication Skills on Patients’ Clinical Outcomes: A Systematic Review,” Journal of Manipulative and Physiological Therapeutics 38(8) (2015): 601–616; Kravitz, R. L. et al. “Influence of Patient Coaching on Analgesic Treatment Adjustment: Secondary Analysis of a Randomized Controlled Trial,” Journal of Pain Symptom Management 43 (2012): 874–884; Sarinopoulos, I. et al. “Patient–centered Interviewing is Associated with Decreased Responses to Painful Stimuli: An Initial fMRI Study,” Patient Education and Counseling 90(2) (2013): 220–225.

24. Street Jr., R. L. et al. “Exploring Communication Pathways to Better Health: Clinician Communication of Expectations for Acupuncture Effectiveness,” Patient Education and Counseling 89 (2012): 245–251.

25. Epstein, R. M. et al. “Patient–Centered Communication and Diagnostic Testing,” Annals of Family Medicine September-October 3(5) (2005): 415-421; Stewart, M., B. L. Ryan, and C. Bodea. “Is Patient–centred Care Associated with Lower Diagnostic Costs?,” Health Policy May 6(4) (2011): 27–31. Both studies are in the family medicine literature. The Epstein study found decreased costs but also increased visit length.

26. Wright, A. A. et al. “Associations Between End–of–Life Discussions, Patient Mental Health, Medical Care Near Death, and Caregiver Bereavement Adjustment,” Journal of the American Medical Association 300(14) (2008): 1665–1673; Zhang, B. et al. “Health Care Costs in the Last Week of Life: Associations with End–of–life Conversations,” Archives of Internal Medicine Journal March 169(5) (2009): 480–488.

27. Kelley, J. M. et al. “The Influence of the Patient–clinician Relationship on Healthcare Outcomes: A Systematic Review and Meta–analysis of Randomized Controlled Trials,” PLoS One 9(4) (2014): e94207.

28. Baker, L., D. O’Connell, and F. Platt. “‘What else?’ Setting the Agenda for the Clinical Interview,” Annals of Internal Medicine November 143(10) (2005): 766–770; White, J., W. Levinson, and D. Roter. “ ‘Oh, by the way …’ The Closing Moments of the Medical Visit,” Journal of General Internal Medicine 9 (1994): 24–28.

29. Marvel, M. K. et al. “Soliciting the Patient’s Agenda: Have We Improved?,” Journal of the American Medical Association 281 (1999): 283–287.

30. Farrell, M. H., and S. A. Christopher. “Frequency of High–quality Communication Behaviors Used by Primary Care Providers of Heterozygous Infants After Newborn Screening,” Patient Education and Counseling 90(2) (2013): 226–232; Levinson, W., P. Hudak, and A. Tricco. “Systematic Review of Surgeon–patient Communication. Strengths and Opportunities for Improvement,” Patient Education and Counseling 93(1) (2013): 3–17; McInnes, I. B., B. Combe, and G. Burmester. “Understanding the Patient Perspective—Results of the Rheumatoid Arthritis: Insights, Strategies & Expectations (RAISE) Patient Needs Survey,” Clinical and Experimental Rheumatology May-June 31(3) (2013): 350–357.

31. Haywood Jr., C. et al. “An Unequal Burden: Poor Patient–provider Communication and Sickle Cell Disease,” Patient Education and Counseling 96 (2) (2014): 159–164; Smith, A. et al. “Sharing vs Caring: The Relative Impact of Sharing Decisions Versus Managing Emotions on Patient Outcomes,” Patient Education and Counseling 82 (2001): 233–239; Weissman, J. S. et al. “Resident Physicians’ Preparedness to Provide Cross–cultural Care,” Journal of the American Medical Association 294 (2005): 1058–1067.

32. Farrell, M. H., et al., op cit; Acher, A. et al. “Using Human Factors and Systems Engineering to Evaluate Readmission After Complex Surgery,” Journal of the American College of Surgeons October 221(4) (2015): 810–820; Deuster, L. et al. “A Method to Quantify Residents’ Jargon Use During Counseling of Standardized Patients About Cancer Screening,” Journal of General Internal Medicine December 23(12) (2008): 1947–1952; Slatore, C. G. et al. “Distress and Patient–centered Communication Among Veterans with Incidental (not Screen–detected) Pulmonary Nodules. A Cohort Study,” Annals of the American Thoracic Society 12(2) (2005): 184–192.

33. Coppola, K. M. et al. “Accuracy of Primary Care and Hospital–based Physicians’ Predictions of Elderly Outpatients’ Treatment Preferences with and Without Advance Directives,” Archives of Internal Medicine 161 (2001): 431–440; Gulbrandsen, P. et al. “Confusion in and About Shared Decision Making in Hospital Outpatient Encounters,” Patient Education and Counseling September 96(3) (2014): 287–294; Levinson, W. et al., 2013, op. cit; Mulley, A. G., C. Trimble, and G. Elwyn. “Stop the Silent Misdiagnosis: Patients’ Preferences Matter,” British Medical Journal 345 (2012): e6572; Smith, A. et al., op. cit; Zikmund–Fisher, B. J. et al. “The DECISIONS Study: A Nationwide Survey of United States Adults Regarding Common Medical Decisions,” Medical Decision Making 30 (2010): 20S–34S.

34. Nagraj, S. et al. “Changing Practice as a Quality Indicator for Primary Care: Analysis of Data on Voluntary Disenrollment from the English GP Patient Survey,” BMC Family Practice June 25 (14) (2013): 89.

35. Acher, A. et al. “Using Human Factors and Systems Engineering to Evaluate Readmission After Complex Surgery,” Journal of the American College of Surgeons October 221(4) (2015): 810–820.

36. Ambady, N. et al. “Surgeons’ Tone of Voice: A Clue to Malpractice History,” Surgery 132 (2002): 132:5–9; Domino, J. et al. “Lack of Physician–patient Communication as a Key Factor Associated with Malpractice Litigation in Neonatal Brachial Plexus Palsy,” Journal of Neurosurgery Pediatrics February 13(2) (2014): 238–242; Hickson, G. B., and S. S. Entman. “Physician Practice Behavior and Litigation Risk: Evidence and Opportunity,” Clinical Obstetrics and Gynecology December 51(4) (2008): 688–699; Levinson, W. et al. “Clinician–patient Communication. The Relationship with Malpractice Claims Among Primary Care Clinicians and Surgeons,” Journal of the American Medical Association 277 (1997): 553–559; Dmochowski, R. R. et al. “Medical Malpractice Claims Risk in Urology: An Empirical Analysis of Patient Complaint Data,” The Journal of Urology May 183(5) (2010): 1971–1976; Vincent, C., M. Young, and A. Phillips. “Why Do People Sue Doctors? A Study of Patients and Relatives Taking Legal Action,” The Lancet June 343(8913) (1994): 1609–1613.

37. Baker, L. et al., op. cit.

38. Pollak, K. et al., op cit.

39. Luxford, K. et al., op. cit.

40. Krasner, M. S. et al. “Association of an Education Program in Mindful Communication with Burnout, Empathy, and Attitudes Among Primary Care Physicians,” Journal of the American Medical Association 302 (2009): 1284–1293.

41. Boissy, A. et al. “Communication Skills Training for Physicians Improves Patient Satisfaction,” Journal of General Internal Medicine 1(7) (2016): 755–761.

42. Bonvicini, K. A. et al. “Impact of Communication Training on Physician Expression of Empathy,” Patient Education and Counseling 75 (2009): 3–10; Brock, D. M. et al. “Effectiveness of Intensive Physician Training in Upfront Agenda Setting,” Journal of General Internal Medicine November 26(1) (2011): 1317–1323; Kennedy, D. M., J. P. Fasolino, and D. J. Gullen. “Improving the Patient Experience Through Provider Communication Skills Building,” Patient Experience Journal 1(1) (2014): 56–60; Record, J. D. et al., op cit.; Riess, H. et al. “Empathy Training for Resident Physicians: A Randomized Controlled Trial of a Neuroscience–informed Curriculum,” Journal of General Internal Medicine 27 (2012): 1280–1286.

43. Pollak, K. et al., op cit.

44. Helitzer, D. L. et al. “A Randomized Controlled Trial of Communication Training with Primary Care Providers to Improve Patient–centeredness and Health Risk Communication,” Patient Education and Counseling 82(1) (2011): 21–29; Yuen, J. K. et al. “A Brief Educational Intervention to Teach Residents Shared Decision Making in the Intensive Care Unit,” Journal of Palliative Medicine May 16(5) (2013): 531–536.

45. Lee, A. L., E. M. Mader, and C. P. Morley. “Teaching Cross–cultural Communication Skills Online: A Multi–method Evaluation,” Family Medicine April 47(4) (2015): 302–308.

46. Asuncion, A. et al. “A Curriculum to Improve Residents’ End–of–Life Communication and Pain Management Skills During Pediatrics Intensive Care Rotation: Pilot Study,” Journal of Graduate Medical Education September 5(3) (2013): 510–513; Markin, A. et al. “Impact of a Simulation–based Communication Workshop on Resident Preparedness for End–of–life Communication in the Intensive Care Unit,” Critical Care Research and Practice (2015): 534879.

47. Ericsson, K. A. “Deliberate Practice and the Acquisition and Maintenance of Expert Performance in Medicine and Related Domains,” Academic Medicine 79(10 Suppl) (2004): S70–81.

48. Berkhof, M. et al. “Effective Training Strategies for Teaching Communication Skills to Physicians: An Overview of Systematic Reviews,” Patient Education and Counseling 84 (2011): 152–162.

Chapter 2

  1. Lee, T. H. “The Word that Shall Not Be Spoken,” New England Journal of Medicine 369 (November 7, 2013): 1777–1779.

  2. Boissy, A. et al. “Communication Skills Training for Physicians Improves Patient Satisfaction,” Journal of General Internal Medicine 7 (July 31, 2016): 755–761.

  3. Centers for Medicare & Medicaid Services (CMS). “Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Fact Sheet.” Baltimore, MD: CMS, June 2015. http://www.hcahpsonline.org/Files/HCAHPS_Fact_Sheet_June_2015.pdf.

  4. Centers for Medicare & Medicaid Services (CMS). “Hospital Value-Based Purchasing,” last modified February 15, 2017, https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/hospital-value-based-purchasing/index.html?redirect=/hospital-value-based-purchasing/.

  5. Wolf, J. A. et al. “Defining Patient Experience,” Patient Experience Journal 1, no. 1 (2014): 7–19.

  6. LaVela, S. L., and A. S. Gallan. “Evaluation and Measurement of Patient Experience,” Patient Experience Journal 1, no. 1 (2014): 28–36.

  7. Barry, M. J., and S. Edgman-Levitan. “Shared Decision Making—The Pinnacle of Patient-Centered Care,” New England Journal of Medicine 366 (2012): 780–781.

  8. Balogh, E. P., B. T. Miller, and J. R. Ball, eds. Improving Diagnosis in Health Care: Consensus Studies Report. Washington, DC: National Academies Press, 2015.

  9. Oshima, E., and E. J. Emmanuel. “Shared Decision Making to Improve Care and Reduce Costs,” New England Journal of Medicine 368 (2013): 6–8.

10. Marvel, M. K. et al. “Soliciting the Patient’s Agenda: Have We Improved?,” JAMA 281 (January 20, 1999): 283–287.

11. Dwamena, F. et al. “Interventions for Providers to Promote a Patient-Centred Approach in Clinical Consultations,” Cochrane Database of Systematic Reviews 12 (2012): 1–160.

12. Weiss, R., E. Vittinghoff, and W. G. Anderson. “Hospitalist Empathy Is Associated with Decreased Patient Anxiety and Higher Ratings of Communication in Admission Encounters,” Society of Hospital Medicine Meeting Abstracts 11 (2016).

13. Safran, D. G., W. Miller, and H. Beckman. “Organizational Dimensions of Relationship-Centered Care. Theory, Evidence, and Practice,” Journal of General Internal Medicine 21 (2006): S9–15.

14. Lichstein, P. R. “Returning to the Bedside: Notes from a Clinical Educator,” North Carolina Institute of Medicine Journal 76, no. 3 (2015): 174–179.

15. Kahn, M. W. “Etiquette-Based Medicine,” The New England Journal of Medicine 358 (2008): 1988–1989.

16. Lehmann, L. S. et al. “The Effect of Bedside Case Presentations on Patients’ Perceptions of Their Medical Care,” The New England Journal of Medicine 336 (1997): 1150–1155.

17. Stein, J. et al. “A Remedy for Fragmented Hospital Care,” Harvard Business Review. November 20, 2013, https://hbr.org/2013/11/a-remedy-for-fragmented-hospital-care.

18. Wofford, M. M. et al. “Patient Complaints about Physician Behaviors: A Qualitative Study,” Academic Medicine 79, no. 2 (February 2004): 134–138.

Chapter 3

  1. Hammerstein II, O., and R. Rodgers. “Do-Re-Mi.” The Sound of Music. RCA Victor, 1965. CD recording.

  2. Wallace, L. S. et al. “Setting the Stage: Surgery Patients’ Expectations for Greetings During Routine Office Visits,” Journal of Surgical Research 157 (2009): 91–95.

  3. Swayden, K. J. et al. “Effect of Sitting vs. Standing on Perception of Clinician Time at Bedside: a Pilot Study,” Patient Education Counseling 86, no. 2 (February 2012): 166–71.

  4. Marvel, M. K. et al. “Soliciting the Patient’s Agenda: Have We Improved?,” JAMA 281, no. 3 (January 20, 1999): 283–287.

  5. White, J., W. Levinson, and D. Roter. “ ‘Oh, by the way … ’: The Closing Moments of the Medical Visit,” Journal of General Internal Medicine 9, no. 1 (1994): 24–28.

Chapter 4

  1. Halpern, J. “From Idealized Clinical Empathy to Empathic Communication in Medical Care,” Medicine, Health Care, and Philosophy 17, no. 2 (2014): 301–311.

  2. Derksen, F., J. Bensing, and A. Lagro-Janssen. “Effectiveness of Empathy in General Practice: a Systematic Review,” British Journal of General Practice 63, no. 606 (2013): e76–84.

  3. Hojat, M. et al. “Patient Perceptions of Physician Empathy, Satisfaction with Physician, Interpersonal Trust, and Compliance.” International Journal of Medical Education 1 (2010): 83–87.

  4. Kelley, J. M. et al. “The Influence of the Patient-Clinician Relationship on Healthcare Outcomes: a Systematic Review and Meta-Analysis of Randomized Controlled Trials,” PLOS ONE 9, no. 4 (2014): e94207. doi: 10.1371/journal.pone.0094207.

  5. Gallese, V. “Mirror Neurons, Embodied Simulation, and the Neural Basis of Social Identification,” Psychoanalytic Dialogues 19 (2009): 519–536.

  6. Lown, B. “A Social Neuroscience-informed Model for Teaching and Practising Compassion in Health Care,” Medical Education, 50 (2016): 332–342. doi: 10.1111/medu.12926.

  7. Levinson, W., R. Gorawara-Bhat, and J. Lamb. “A Study of Patient Cues and Physician Responses in Primary Care and Surgical Settings,” JAMA 284 (2000): 1021–1027.

  8. Suchman, A. et al. “A Model of Empathic Communication in the Medical Interview,” JAMA 277 (1997): 678–682.

Chapter 5

  1. Whyte, W. H. “Is Anybody Listening?,” Fortune 14, no. 3 (September 1950): 174. This quotation is often misattributed to George Bernard Shaw.

  2. Kalet, A., and C. Chou, eds. Remediation in Medical Education: A Mid-Course Correction. New York: Springer, 2014.

  3. Moral, R. R. et al. “Effectiveness of Motivational Interviewing to Improve Therapeutic Adherence in Patients over Sixty-Five Years Old with Chronic Diseases: A Cluster Randomized Clinical Trial in Primary Care,” Patient Education and Counseling 98, no. 8 (August 2015): 977–983; Kelley, J. M. et al. “The Influence of the Patient-Clinician Relationship on Healthcare Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials,” PLOS ONE 9, no. 4 (2014): e9420; Rocco, N. et al. “Patient-Centered Plan-of-Care Tool for Improving Clinical Outcomes,” Quality Management in Health Care 20, no. 2 (April–June 2011): 89–97.

  4. Yin, H. S. et al. “Liquid Medication Dosing Errors in Children: Role of Provider Counseling Strategies,” Academic Pediatrics 14, no. 3 (May–June 2014): 262–270.

  5. Pollak, K. et al. “Effect of Teaching Motivational Interviewing via Communication Coaching on Clinician and Patient Satisfaction in Primary Care and Pediatric Obesity-Focused Offices,” Patient Education and Counseling 99, no. 2 (February 2016): 300–303.

Chapter 6

  1. Murthy, V. H. “Ending the Opioid Epidemic: A Call to Action,” New England Journal of Medicine 375 (December 22, 2016): 2413–2415.

  2. Saha, S., J. J. Arbelaez, and L. A. Cooper. “Patient-Physician Relationships and Racial Disparities in the Quality of Health Care,” American Journal of Public Health 93, no. 10 (2003): 1713–1719.

Chapter 7

  1. Pearce, C. et al. “Doctor, Patient, and Computer—A Framework for the New Consultation,” Journal of the American Medical Informatics Association 78 (2009): 32–38.

  2. Blumenthal, D., and M. Tavenner. “The ‘Meaningful Use’ Regulation for Electronic Health Records,” The New England Journal of Medicine 363 (2010): 501–504. PubMed, http://dx.doi.org/10.1056/NEJMp1006114.

  3. Toll, E. “A Piece of My Mind. The Cost of Technology,” The Journal of the American Medical Association 307, no. 23 (2012): 2497–2498.

  4. Margalit, R. S. et al. “Electronic Medical Record Use and Physician-Patient Communication: an Observational Study of Israeli Primary Care Encounters,” Patient Education and Counseling 61, no. 1 (April 2006): 134–141.

  5. Ferkeitich, A. K., and D. J. Frid. “Depression and Coronary Heart Disease: a Review of the Literature,” Clinics in Geriatric Medicine 9 (2001): 50–56.

  6. Harman, J. S. et al. “Electronic Medical Record Availability and Primary Care Depression Treatment,” Journal of General Internal Medicine 27, no. 8 (August 2012): 962–967.

  7. Ratanawongsa, N. et al. “Association Between Clinician Computer Use and Communication with Patients in Safety-Net Clinics,” The Journal of the American Medical Association Internal Medicine 176, no. 1 (2016): 125–128.

  8. Verghese, A. “Culture Shock—Patient as Icon, Icon as Patient,” The New England Journal of Medicine 359, no. 26 (2008): 2748–2751.

  9. Sinsky, C. et al. “Allocation of Physician Time in Ambulatory Practice: a Time and Motion Study in Four Specialties,” Annals of Internal Medicine 165 (2016): 753–760.

10. Shanafelt, T. D. et al. “Relationship between Clerical Burden and Characteristics of the Electronic Environment with Physician Burnout and Professional Satisfaction,” Mayo Clinic Proceedings 91, no. 7 (July 2016): 836–848.

11. Sinsky, C. “Texting While Doctoring a Patient Safety Hazard,” Annals of Internal Medicine 159, no. 11 (2013): 782–783.

12. Frankel, R. M., and J. J. Saleem. “Attention on the Flight Deck: What Ambulatory Care Clinicians Can Learn from Pilots about Complex Coordinated Actions,” Patient Education and Counseling 93, no. 3 (December 2013): 367–372.

13. Graber, M. L. et al. “Electronic Health Record-Related Events in Medical Malpractice Claims,” Journal of Patient Safety (November 6, 2015): doi: 10.1097/PTS.0000000000000240.

14. Duke, P., R. M. Frankel, and S. Reis. “How to Integrate the Electronic Health Record and Patient-Centered Communication Into the Medical Visit: A Skills-Based Approach,” Teaching and Learning in Medicine 25, no. 4 (2013): 358–365.

15. Woodcock, E. W. Mastering Patient Flow to Increase Efficiency and Earnings. Englewood, CO: Medical Group Management Association, 2000.

16. Cuddy, A. Presence: Bringing Your Boldest Self to Your Biggest Challenges. Boston, MA: Little, Brown and Company, 2015.

17. Toll, E. “A Piece of My Mind. The Cost of Technology,” The Journal of the American Medical Association 307, no. 23 (2012): 2497–2498.

Chapter 8

  1. Senge, P. M. The Fifth Discipline: The Art and Practice of the Learning Organization. New York: Doubleday, 1990.

  2. Miller, W. R., and S. Rollnick. Motivational Interviewing: Helping People Change. New York: The Guilford Press, 2013.

  3. Ibid.

  4. As the originators of motivational interviewing, Miller and Rollnick continue to be the definitive source on MI. They have updated the theory and model over the years, but both the spirit and the techniques described here draw heavily on their pioneering work and remain a cornerstone of MI. For a more in-depth read, see their book (2013), particularly Chapters 2, 6, 8, and 13.

Chapter 9

  1. Mulley, A., C. Trimble, and G. Elwyn. “Stop the Preference Misdiagnosis: Patients’ Preferences Matter,” British Medical Journal 345 (2012): e6572; Hoffman, R. M. et al. “Prostate Cancer Screening Decisions: Results from the National Survey of Medical Decisions (DECISIONS Study),” Archives of Internal Medicine 169, no. 17 (2009): 1611–1618, doi: 10.1001/archinternmed.2009.26; Ling, B. S. et al. “Informed Decision-making and Colorectal Cancer Screening. Is it Occurring in Primary Care?,” Medical Care 46 (2008): S23–29; Coppola, K. M. et al. “Accuracy of Primary Care and Hospital-Based Physicians’ Predictions of Elderly Outpatients’ Treatment Preferences with and without Advance Directives,” Archives of Internal Medicine 161 (2001): 431–440; Zikmund-Fisher, B. J. et al. “The Decisions Study: a Nationwide Survey of United States Adults Regarding Common Medical Decisions,” Medical Decision-making 30 (2010): 20S–34S.

  2. Ling, B. S. et al. “Informed Decision-making and Colorectal Cancer Screening. Is it Occurring in Primary Care?,” Medical Care 46 (2008): S23–29.

  3. Ling, B. S. et al. “Informed Decision-making and Colorectal Cancer Screening. Is it Occurring in Primary Care?,” Medical Care 46 (2008): S23–29; Coppola, K. M. et al. “Accuracy of Primary Care and Hospital-Based Physicians’ Predictions of Elderly Outpatients’ Treatment Preferences with and without Advance Directives,” Archives of Internal Medicine 161 (2001): 431–440; Zikmund-Fisher, B. J. et al. “The Decisions Study: a Nationwide Survey of United States Adults Regarding Common Medical Decisions,” Medical Decision-making 30 (2010): 20S–34S.

  4. Hoffman, R. M. et al. “Prostate cancer screening decisions: results from the National Survey of Medical Decisions (DECISIONS study),” Archives of Internal Medicine 169 (2009): 1611-1618.

  5. Institute of Medicine (US) Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington (DC): National Academies Press (US) (2001).

  6. Hibbard, J. H., and Greene, J. “What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs,” Health Affairs 32, no. 2 (2013): 207-214.

  7. Elwyn, G., A. Edwards, and R. Thompson, eds. Shared Decision Making in Health Care: Achieving Evidence-based Patient Choice. 3rd ed. Oxford: Oxford University Press, 2016. Oxford Scholarship Online, 2016. doi: 10.1093/acprof:oso/9780198723448.001.0001.

  8. Fisher, B. et al. “Twenty-Year Follow-Up of a Randomized Trial Comparing Total Mastectomy, Lumpectomy, and Lumpectomy Plus Irradiation for the Treatment of Invasive Breast Cancer,” The New England Journal of Medicine 347 (2002): 1233–1241; Veronesi, U. et al. “Twenty-Year Follow-Up of a Randomized Study Comparing Breast-Conserving Surgery with Radical Mastectomy for Early Breast Cancer,” The New England Journal of Medicine 347 (2002): 1227–1232; Collins, E. D. et al. “Can Women with Early-Stage Breast Cancer Make an Informed Decision for Mastectomy?,” Journal of Clinical Oncology 27 (2008): 519–525.

  9. Mulley, A., C. Trimble, and G. Elwyn. “Stop the Preference Misdiagnosis: Patients’ Preferences Matter,” British Medical Journal 345 (2012): e6572.

10. Greene, J. et al. “When Patient Activation Levels Change, Health Outcomes and Costs Change, Too,” Health Affairs 34, no. 3 (2015): 431–437.

11. Paling, J. “Strategies to Help Patients Understand Risks,” British Medical Journal 327 (2003): 745–748; Gigerenzer, G. et al. “Helping Doctors and Patients Make Sense of Health Statistics,” Association of Psychological Science 8, no. 2 (2008): 53–96.

12. Collins, E. D. et al. “Can Women with Early-Stage Breast Cancer Make an Informed Decision for Mastectomy?,” Journal of Clinical Oncology 27 (2008): 519–525.

13. Houts, P. S. et al. “Using Pictographs to Enhance Recall of Spoken Medical Instructions,” Patient Education and Counseling 35 (1998): 83–88.

14. Stacey, D. et al. “Decision Aids for People Facing Health Treatment or Screening Decisions,” Cochrane Database of Systematic Reviews (January 28 2014): doi: 10.1002/14651858.CD001431.pub4.

15. “Osteoporosis Decision Aid,” Mayo Clinic Shared Decision-making National Resource Center, version 3.4.4, accessed January 4, 2017. https://osteoporosisdecisionaid.mayoclinic.org/index.php/osteo.

Chapter 10

  1. Van de Ridder, J. M. et al. “What Is Feedback in Clinical Education?,” Medical Education 42, no. 2 (2008): 189–197.

  2. Gottman, J., and R. W. Levenson. “What Predicts Change in Marital Interaction over Time? A Study in Alternative Methods,” Family Processes Journal 38.2 (1999): 143–158.

Chapter 11

  1. Gawande, A. “Personal Best,” The New Yorker October 3, 2011, http://www.newyorker.com/magazine/2011/10/03/personal-best.

  2. The Associated Press. “Joe Maddon Keeps His Cubs Moving, and Guessing,” The New York Times July 9, 2016, https://www.nytimes.com/2016/07/10/sports/baseball/joe-maddon-keeps-his-cubs-moving-and-guessing.html?_r=0.

  3. Cooperrider, D., and D. Whitney. Appreciative Inquiry: A Positive Revolution in Change. San Francisco: Berrett-Koehler Publishers, Inc., 2005.

Chapter 12

  1. Gawande, A. “Cowboys and Pit Crews.” The New Yorker May 26, 2011, http://www.newyorker.com/news/news-desk/cowboys-and-pit-crews.

  2. “TeamSTEPPS 2.0,” Agency for Healthcare Research and Quality, Rockville, MD. Last modified September 2016, accessed March 17, 2017. https://www.ahrq.gov/teamstepps/instructor/index.html.

  3. Stock, R. et al. “Measuring Team Development in Clinical Care Settings,” Family Medicine 45 (2013): 691–700.

  4. Lencioni, P. The Five Dysfunctions of a Team: A Leadership Fable. San Francisco: Jossey-Bass, 2002.

  5. Shunk, R. et al. “Huddle-Coaching: a Dynamic Intervention for Trainees and Staff to Support Team-Based Care,” Academic Medicine 89 (2014): 244–250.

Chapter 13

  1. The Joint Commission. “Behaviors that Undermine a Culture of Safety,” Sentinel Event Alert, no. 40. July 9, 2008, http://www.jointcommission.org/sentinel_event_alert_issue_40_behaviors_that_undermine_a_culture_of_safety/.

  2. Riskin, A. et al. “The Impact of Rudeness on Medical Team Performance: A Randomized Trial,” Pediatrics 136 (August 2015): 487–495.

  3. Haraway, D. L., and W. M. Haraway. “Analysis of the Effect of Conflict-Management and Resolution Training on Employee Stress at a Healthcare Organization,” Hospital Topics 83, no. 4 (February 2005): 11–17.

  4. “Mehrabian’s Communication Research: Professor Albert Mehrabian’s Communications Model,” Businessballs, accessed March 19, 2017. http://www.businessballs.com/mehrabiancommunications.htm.

  5. Senge, P. M. et al. The Fifth Discipline Fieldbook: Strategies and Tools for Building a Learning Organization. New York: Crown Business, 1994.

  6. Kahneman, D. Thinking, Fast and Slow. New York: Farrar, Straus and Giroux, 2011.

  7. Fisher, R., W. L. Ury, and B. Patton. Getting to Yes, 3rd ed. New York: Penguin Books, 2011.

  8. Ibid.

  9. Stone, D., B. Patton, and S. Heen. Difficult Conversations: How to Discuss What Matters Most. New York: Penguin Books, 2010.

Chapter 14

  1. Cooper-Patrick, L. et al. “Race, Gender, and Partnership in the Patient-Physician Relationship,” JAMA 282 (August 11, 1999): 583–589.

  2. Betancourt, J. R., and R. K. King. “Unequal Treatment: The Institute of Medicine Report and its Public Health Implications,” Public Health Reports 118, no. 4 (July–Aug 2003): 287–292.

  3. National Institute of Diabetes and Digestive and Kidney Diseases. “A Summary Report. National Kidney Disease Education Program: Reducing Disparities, Improving Care.” Washington DC: NIH Publication 14–7381.2014. Accessed from https://www.niddk.nih.gov/health-information/health-communication-programs/nkdep/about-nkdep/summary/Documents/nkdep-summary-report-508.pdf on March 18, 2017.

  4. Buchmueller, T., and C. S. Carpenter. “Disparities in Health Insurance Coverage, Access, and Outcomes for Individuals in Same-Sex Versus Different-Sex Relationships, 2000–2007,” American Journal of Public Health 100, no. 3 (March 2010): 489–495.

  5. Kandula, N. R. et al. “Low Rates of Colorectal, Cervical, and Breast Cancer Screening in Asian Americans Compared With Non-Hispanic Whites,” Cancer 107, no. 1 (2006): 184–192.

  6. Cooper-Patrick, L. et al. “Race, Gender, and Partnership in the Patient-Physician Relationship,” JAMA 282 (August 11, 1999): 583–589.

  7. Mays, V. M. “Research Challenges and Bioethics Responsibilities in the Aftermath of the Presidential Apology to the Survivors of the U. S. Public Health Services Syphilis Study at Tuskegee,” Ethics & Behavior 22, no. 6 (2012): 419–430.

  8. Stepanikova, I., and G. R. Oates. “Perceived Discrimination and Privilege in Healthcare: The Role of Socioeconomic Status and Race,” American Journal of Preventive Medicine 52 (2017): S86–S94.

  9. Cooper-Patrick, L. et al. “Race, Gender, and Partnership in the Patient-Physician Relationship,” JAMA 282 (August 11, 1999): 583–589.

10. Hutzler, L. et al. “Do Internal Medicine Interns Practice Etiquette-Based Communication? A Critical Look at the Inpatient Encounter,” Journal of Hospital Medicine 11 (2013): 631–634.

11. Schoenthaler, A. et al. “Provider Communication Effects Medication Adherence in Hypertensive African Americans,” Patient Education and Counseling 75, no. 2 (2009): 185–191.

12. Diamond, L. et al. “Getting By: Underuse of Interpreters by Resident Physicians,” Journal of General Internal Medicine 24 (2009): 256–262.

13. Chen, P. W. “When the Patient Gets Lost in Translation,” The New York Times (April 23, 2009) http://www.nytimes.com/2009/04/23/health/23chen.html. Accessed March 19, 2017.

14. Betancourt, J. R., and R. K. King. “Unequal Treatment: The Institute of Medicine Report and its Public Health Implications,” Public Health Reports 118, no. 4 (July–Aug 2003): 287–292.

15. Amador, J., P. Flynn, and H. Betancourt. “Cultural Beliefs about Health Professionals and Perceived Empathy Influence Continuity of Cancer Screening Following a Negative Encounter,” Journal of Behavioral Medicine 38 (2015): 798–808.

16. Beach, M. C. et al. “Are Physicians’ Attitudes of Respect Accurately Perceived by Patients and Associated with More Positive Communication Behaviors?,” Patient Education and Counseling 62 (2006): 347–354.

17. Kutner, M. et al. The Health Literacy of America’s Adults: Results from the 2003 National Assessment of Adult Literacy (NCES 2006–483). U.S. Department of Education. Washington, DC: National Center for Education Statistics, 2006.

18. Judson, T. J., A. S. Detsky, and M. J. Press. “Encouraging Patients to Ask Questions: How to Overcome ‘White-Coat Silence,’ ” Journal of the American Medical Association 309 (2013): 2325–2326.

19. Cooper-Patrick, L. et al. “Race, Gender, and Partnership in the Patient-Physician Relationship,” JAMA 282 (August 11, 1999): 583–589.

Chapter 15

  1. A number of studies in recent years have pointed to the association between hierarchy, stress, and health. These include: Tung, J. et al. “Social Environment Is Associated with Gene Regulatory Variation in the Rhesus Macaque Immune System,” Proceedings of the National Academy of Sciences of the United States of America 109, no. 17 (Apr 2012): 6490–6495; Snyder-Mackler, N. et al. “Social Status Alters Immune Regulation and Response to Infection in Macaques,” Science 354, no. 6315 (Nov 25, 2016): 1041–1045; Sapolsky, R. M. “The Influence of Social Hierarchy on Primate Health,” Science 308, no. 5722 (April 29, 2005): 648–652; Cundiff, J. M. et al. “Hierarchy and Health: Physiological Effects of Interpersonal Experiences Associated with Socioeconomic Position,” Health Psychology 35, no. 4 (April 2016): 356–365; Marmot, M. G. et al. “Health Inequalities among British Civil Servants: The Whitehall II Study,” The Lancet 337, no. 8754 (June 08, 1991): 1387–1393; Wilkinson, R. G. Mind the Gap—Hierarchies, Health, and Human Evolution. London: Weiderfeld and Nicolson, 2000.

  2. Tsao, K., and M. Browne. “Culture of Safety: A Foundation for Patient Care,” Seminars in Pediatric Surgery 24, no. 6 (December 2015): 283–287.

  3. Angoff, N. et al. “Power Day: Addressing the Use and Abuse of Power in Medical Training,” Journal of Bioethical Inquiry 13, no. 2 (June 2016): 203–213.

  4. For further details on building a just culture, the following references can be helpful: Boysen, P. G., 2nd. “Just Culture: A Foundation for Balanced Accountability and Patient Safety,” Ochsner Journal 13, no. 3 (September 2013): 400–406; Marx, D. “Patient Safety and the ‘Just Culture’: A Primer for Health Care Executives” (2001). http://www.chpso.org/sites/main/files/file-attachments/marx_primer.pdf; Pepe, J., and P. J. Cataldo. “Manage Risk, Build a Just Culture,” Health Progress 92, no. 4 (July–August 2011): 56–60.

Chapter 16

  1. Berkhof, M. et al. “Effective Training Strategies for Teaching Communication Skills to Physicians: an Overview of Systematic Reviews,” Patient Education and Counseling 84 (2011): 152–162.

Chapter 17

  1. Chou, C. et al. “The Impact of a Faculty Learning Community on Professional and Personal Development: the Facilitator Training Program of the American Academy on Communication in Healthcare,” Academic Medicine 89 (2014): 1051–1056.

  2. Ferguson, K. J. et al. “Defining and Describing Medical Learning Communities: Results of a National Survey,” Academic Medicine 84 (2009): 1549–1556.

  3. Kotter, J. P. “Leading Change: Why Transformation Efforts Fail,” Harvard Business Review 73 (1995): 59–67.

  4. Chou, C. L. et al. “Enhancing Patient Experience by Training Local Trainers in Fundamental Communication Skills,” Patient Experience Journal 1(2) (2014): 36–45.

  5. Berkhof, M. et al. “Effective Training Strategies for Teaching Communication Skills to Physicians: an Overview of Systematic Reviews,” Patient Education and Counseling 84 (2011): 152–162.

  6. Ericsson, K. A. “Deliberate Practice and the Acquisition and Maintenance of Expert Performance in Medicine and Related Domains,” Academic Medicine 79, no.10 Suppl (2004): S70–81.

  7. Frankel, R. M., and T. Stein. “Getting the Most Out of the Clinical Encounter: the Four Habits Model,” Permanente Journal 3 (1999): 79–88.

  8. Chou, C. L. et al. “Enhancing Patient Experience by Training Local Trainers in Fundamental Communication Skills,” Patient Experience Journal 1(2) (2014): 36–45.

  9. U.S. News Health. Accessed August 12, 2017. http://health.usnews.com/best-hospitals/area/az/mayo-clinic-6860019

10. Kennedy, D. M., J. P. Fasolino, and D. J. Gullen. “Improving the Patient Experience Through Provider Communication Skills Building,” Patient Experience Journal 1(1) (2014): 56–60.

11. Merlino, J. Service Fanatics: How to Build Superior Patient Experience the Cleveland Clinic Way. New York, NY: McGraw-Hill Education, 2014.

12. Frankel, M., and T. Stein, “Getting the Most Out of the Clinical Encounter: The Four Habits Model,” Journal of Medical Practice Management 16 (2001): 184–191.

13. Windover, A. et al. “The REDE Model of Healthcare Communication: Optimizing Relationship as a Therapeutic Agent,” Journal of Patient Experience (2014); 1(1): 8–13. Note that REDE stands for Relationship: Establishment, Development, and Engagement.

14. G. Makoul, “The SEGUE Framework for Teaching and Assessing Communication Skills,” Patient Education and Counseling 45 (2001): 23–34.

15. Beach, M.C., and T. Inui, Relationship-Centered Care Research Network, “Relationship-Centered Care: A Constructive Reframing,” Journal of General Internal Medicine 21, suppl. 1 (2006): S3–8.

16. Boissy, A., and T. Gilligan, eds. Communication the Cleveland Clinic Way: How to Drive a Relationship-centered Strategy for Exceptional Patient Experience. New York, NY: McGraw-Hill Education, 2016.

17. Boissy, A., et al. “Communication Skills Training for Physicians Improves Patient Satisfaction,” Journal of General Internal Medicine 31(7): 755–761.

18. The CAHPS® Clinician & Group Survey (CG-CAHPS) assesses patients’ experiences with health care providers and staff in doctors’ offices. Accessed April 19, 2017. https://www.cahpsdatabase.ahrq.gov/default.aspx.

19. Boissy, A., and T. Gilligan, eds. Communication the Cleveland Clinic Way: How to Drive a Relationship-centered Strategy for Exceptional Patient Experience. New York, NY: McGraw-Hill Education, 2016.

20. University of Maryland School of Medicine. Accessed May 20, 2017. http://www.medschool.umaryland.edu/about/.

21. University of Maryland School of Medicine. “The Program for Excellence in Patient-Centered Communication.” Accessed April 12, 2017. http://www.medschool.umaryland.edu/programs/pep/.

22. The CAHPS® Clinician & Group Survey (CG-CAHPS) assesses patients’ experiences with healthcare providers and staff in doctors’ offices. Accessed April 19, 2017. https://www.cahpsdatabase.ahrq.gov/default.aspx.

23. U.S. News Health. Accessed May 20, 2017. http://health.usnews.com/best-hospitals/area/ca/san-mateo-medical-center-6933310.

24. Wake Forest Baptist Health System. Accessed May 20, 2017. http://www.wakehealth.edu/About-Us/.

25. Texas Children’s Hospital. Accessed May 26, 2017. http://www.texaschildrens.org/about-us/news/releases/texas-childrens-hospital-ranks-4th-nationally-among-all-childrens-hospitals.

26. University of California San Francisco. “The Center for Enhancement of Communication in Healthcare: Testimonials.” Accessed April 12, 2017. http://cech.ucsf.edu/testimonials.

27. Based on internal evaluation surveys collected immediately after participants attended the one-day program.