As medical systems shift from the provision of acute to chronic care and the large baby boomer cohort enters the geriatric age range, today's medical trainees will, proportionately, treat more patients with chronic conditions than did their predecessors. Effectively attending to complex co-morbid conditions requires far greater emphasis on patient education and on motivating lifestyle change, and significantly more coordination of care between patients, family members and health care teams. Never before has the quality of health care exchange in medicine been as important, not only in terms of the quality of the content of the exchange, but also the quality of the context in which information is exchanged so that trust building and mutual reciprocal interactions take place. Effective and attuned health care communication is associated with greater patient and provider satisfaction, higher levels of shared decision making, and better treatment adherence and outcomes.
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