None of the changes rattling modern medicine has eliminated the need for effective patient communications. And none of them ever will. Indeed, the last decade's changes, and those ahead, make clear communication between patient and physician more critical to quality outcomes than ever before. Here are a few fresh ideas from your colleagues.

1 Use Technology.
Before a visit occurs, keep the lines of communication open with technology designed to help you do just that. "We use an automated, computerized patient reminder system that calls a patient the night before an appointment and records for us whether a human being or a machine or voice mail was reached," notes Encino-based ophthalmologist and Los Angeles County Medical Association president David H. Aizuss, MD.

2 Be Positive If Possible.
During office visits, be realistic, in a positive way. "When I start patients on a chronic medication-such as an anti-hypertensive, heart medication or an asthma controller-they often ask me, 'Will I have to take this for the rest of my life?'" notes Alan E. Gorenberg, MD, FAAP, an Orange-based allergist. "I respond that they most likely will not, because of the rapid advances in medicine. They will probably be on it for a few years until a better treatment comes along." That, he reports, dramatically improves patients' acceptance of the therapy.

3 Invest Time.
Invest time in getting patients to their own comfort level with what you need for them to know. "Always ask if the patient understands," urges Garden Grove-based pulmonary disease specialist and California Medical Association president Richard Frankenstein, MD, FACP. "And with particularly critical aspects of patient care, ask the patient to demonstrate his or her understanding of what you've recommended." Avoid cutting that process short by inadvertently using the classic signals that time's up. "Assure the patient that you will spend the time necessary to clarify things," Dr. Frankenstein says. "Avoid body language-closing the chart, getting up, placing your hand on the examining room doorknob-that might indicate the patient needs to leave."

4 Educate the Patient.

Invest time in quick, onsite patient education. "I give handouts and homework to patients, because I know they won't remember everything I told them," says Oxnard pediatrician Danielle Onstot, MD, FAAP. "I often write down instructions so they don't forget what I told them. Taking the time to educate patents saves time in the long run." For example, she takes a moment to explain that it may take two or three days for a fever to go away after prescribing antibiotics, so the family doesn't call complaining about a fever after the first dose. That tactic also helps when a patient with significant medical issues, scared about what he or she is hearing, doesn't catch details.

5 Stick to the Issues.
Taking a sexual history is important, but a lot of doctors are hesitant to do it because they feel uncomfortable asking questions like, "Are you homosexual?" But the direct question helps physicians get to the point, notes Marshall Morgan, MD, a Los Angeles-area emergency medicine specialist. "It's matter-of-fact in nature and asks for the information you need to know in a non-judgmental-sounding way. And I find that patients are not offended by it: "Are you sexually active? Do you have sex with men or women or both?"

6 Get to the Point.
"When a patient might perceive the potential for bad news, but there isn't any, start the visit with, 'I have good news' or 'There's only good news'," Dr. Frankenstein recommends. "When a patient is anxious and the doctor presents a physiology lesson, that patient can become so involved in what the physician seems to want him or her to understand that the actual conclusion-the good news-goes unnoticed."

7 Get Speedy Test Results.
After a visit, get test results in patients' hands as quickly as possible-as quickly as humanely possible, that is. "I dictate a letter to every one of my patients with their test results the day of or the day after," Dr. Aizuss reports. "We use a digital transcription service with same-day turnaround. Patients generally have their results within 72 hours." But, he stresses, "I always call patients if the results are serious or abnormal, requiring further discussion or evaluation."

8 Ensure Accuracy.
Enlist your office team in making sure patient communications are accurate. "Alert the staff to advise you if a patient needs additional information or clarification," Dr. Frankenstein suggests. "The patient may not tell you, and the staff member he or she asks may not be qualified to provide the information the patient seeks."

9 Use Mental Placebos.
A psychological placebo never hurts. Every patient in Dr. Aizuss' practice receives a detailed sheet with color pictures of their individual medications. "Finally," he adds, "I tell patients on their first post-operative visits to call me if they have any difficulty, even on the weekend. I find that patients' knowing they can reach me has actually minimized my calls on weekends."

And finally, a voice you should really hear on the topic of patient communications, that of Ontario-based anesthesiologist Thelma Korpman, MD, MBA: "There are many who believe that certain physicians go into anesthesiology just so they don't have to communicate with patients, because they're asleep during most of the encounter. I believe that just the opposite is true. Anesthesiologists have the distinct job of winning over patients' confidence and trust within a few minutes just prior to administering anesthesia. A patient must trust me with his or her life after a five-minute encounter. A very few reassuring words go a long way in our relationship."