inseparable in the total communication process.
Conscious awareness of this aspect is extremely
important for the health care provider whose pro-
fessional effectiveness is highly dependent upon
Ineffective communication occurs when
obstacles or barriers are present. These barriers
can be classified as physiological, physical, or
psychosocial. Physiological barriers are those that
result from some kind of sensory dysfunction on
the part of either the sender or the receiver. Such
things as hearing impairments, speech defects, and
even vision problems influence the effectiveness
of communication. Physical barriers consist of
elements in the environment (such as noise) that
frequently contribute to the development of
physiological barriers (such as inability to hear).
The final kind of obstacle, called psychosocial
barriers, are usually the result of ones inaccurate
perception of self or others, the presence of some
defense mechanism an individual employs to cope
with some form of threatening anxiety, or fac-
tors such as age, education, culture, language, na-
tionality, and a multitude of other socioeconomic
factors. This last category of barriers is the most
difficult to identify and the most common cause
of communication failure or breakdown.
Listening is a critical element of the com-
munication process and becomes a primary ac-
tivity for the health care provider who must use
communication as a tool for collecting or giving
information. When one is engaged in listening,
it is important to direct attention to both the ver-
bal and nonverbal cues provided by the other
person. Like many other skills necessary for pro-
viding a health care service, the skill of listening
requires conscious effort and constant practice.
Listening skill can be improved and enhanced by
developing the following attitudes and skills:
l Want to listen.
. Develop your interests and knowledge.
. Look at the content of the message.
. Hear the speaker out.
. Focus on ideas.
. Remove or adjust distractions.
. Maintain objectivity.
. Concentrate on the immediate interaction.
As a health care provider, you will be using the
communication process to service a consumers
needs. Briefly, these needs can be classified as
either short-term or long-term. To simplify this
discussion, short-term needs of communication
will be discussed under the heading of contact
point. Long-term needs will be discussed under
the heading of therapeutic communications.
To provide you with a frame of reference for
the following discussion, the following definitions
will clarify and standardize some critical terms:
. Initial contact pointa physical location
where the consumer experiences his or her
first communication encounter with a per-
son representing, in some role, the health
l Contact point the place or event where
the contact point person and the consumer
meet. The contact point meeting can oc-
cur anywhere in a facility and also includes
Contact point personthe health care pro-
vider in any health care experience who is
tasked by role and responsibility to pro-
vide a service to the consumer.
The contact point person has certain criteria
to meet in establishing a good relationship with
the patient. Helping the patient through trying ex-
periences is partially the responsibility of all con-
tact point personnel. Such health care providers
must not only have skills related to their profes-
sional assignment, but they must also have the
ability to interact in a positive, meaningful way
to communicate concern and the desire to pro-
vide a service.
Consumers of health care services expect to
be treated promptly, courteously, and correctly.
They expect their care to be personalized and com-
municated to them in terms they understand. The
Navy health care system is a service system, and
it is the responsibility of every health care pro-
vider to improve the professional nature of the
The significance of the contact point and the
responsibility of the personnel staffing these areas
are important to emphasize. The following
message from a former Surgeon General of the