PHYSICIANS’ COMMUNICATIVE COMPETENCE AS A FACTOR IN PREVENTING CONFLICTS IN PROFESSIONAL PRACTICE

Abstract

Background. Communicative competence is a fundamental component of physicians’ professional effectiveness and an important factor in preventing conflicts within clinical practice. The rapid digitalization of healthcare, widespread adoption of electronic health records, and increasing reliance on technology-mediated interaction have transformed traditional physician–patient communication. These developments may contribute to divided attention, reduced eye contact, weakened empathic engagement, and communication deficits, potentially affecting patient trust, treatment adherence, therapeutic alliance, and the risk of interpersonal and medico-legal conflicts.

Objective. To examine the role of physicians’ communicative competence in preventing professional conflicts by synthesizing evidence on physician–patient interaction and comparing communication patterns characteristic of the pre-digital era with those emerging in contemporary digitalized clinical environments.

Methods. The study employed a theoretical and analytical design based on a comprehensive retrospective review and comparative synthesis of classical and contemporary scientific literature published between 1987 and 2026. The analysis incorporated conceptual modeling and systematic examination of psychological, deontological, clinical, and medico-legal aspects of physician–patient communication. Particular attention was given to empirical evidence concerning non-verbal empathy, electronic health record use, patient-centered communication, treatment adherence, conflict and malpractice risk, therapeutic alliance, and structured communication models.

Results. The reviewed evidence demonstrates a consistent association between the quality of physician–patient communication and clinically relevant psychological, behavioral, and organizational outcomes. Non-verbal empathic behavior was strongly associated with patient satisfaction (r = .80), whereas the use of electronic health records was reported to account for up to 31% of consultation time directed toward the computer screen. Active listening and communication quality were associated with patient satisfaction (r = .54), while communication problems were identified in 71% of malpractice claims in one landmark analysis and accompanied medical errors in approximately 40% of cases in university clinical settings. Effective physician communication was associated with a 1.62-fold increase in the likelihood of treatment adherence. Patient-centered and empathic communication was additionally linked to favorable psychological and selected clinical outcomes, including reduced stress-related responses and improved management of chronic conditions. Evidence concerning structured approaches indicates that implementation of the Calgary–Cambridge model can enhance patient-centered communication without necessarily increasing consultation duration.

Conclusions. Communicative competence should be conceptualized not merely as a supplementary interpersonal skill but as an integral component of professional clinical competence, patient safety, and conflict prevention. Digitalization creates additional cognitive and relational challenges that require physicians to deliberately preserve empathic engagement, active listening, narrative competence, and patient-centered dialogue. The reviewed evidence supports the systematic integration of evidence-based communication training, including structured models such as the Calgary–Cambridge framework, into medical education and continuing professional development. Strengthening physicians’ communicative competence may contribute to maintaining the therapeutic alliance, improving treatment adherence, reducing interpersonal and medico-legal risks, and supporting psychologically safer clinical interactions.

Keywords: communicative competence; physician–patient communication; communication skills; conflict prevention; patient-centered care; healthcare digitalization; therapeutic alliance; treatment adherence; narrative competence; clinical empathy.