There are a number of common barriers to effective communication which you should consider before starting a conversation with a patient:

• Physical barriers, e.g. the pharmacy counter.
• Emotional barriers and taboos, for example many patients will find it embarrassing to talk about sensitive issues such as their weight.
• Lack of attention, interest, distractions, or irrelevance to the patient.
• Differences in perception and viewpoint e.g. some patients don’t see their health behaviours as a problem.
• Patient is not yet ready to make appropriate or necessary change.
• Not using over complicated language, e.g. medical terms, jargon.
• Disabilities:
  • physical, i.e. hearing or speech problems
  • lack of mental capacity or learning difficulties
• Language differences and the difficulty in understanding unfamiliar accents.
• Expectations and prejudices which may lead to false assumptions or stereotyping. People often hear what they expect to hear rather than what is actually said and jump to incorrect conclusions.
• Cultural differences, for example it may be inappropriate to talk about certain topics in other cultures.

Some of these barriers are easier to overcome than others, for example, physical barriers. If you are behind the counter you have a physical barrier between you and the patient, whilst this may be appropriate when you are making a simple transaction it may not be when you are offering advice. Step out from behind the counter, take the patient to one side or in to the consultation room as this may make the patient feel more comfortable and be receptive to the advice you are giving them.

Others are a little more challenging such as emotional barriers and cultural differences but you could offer to take the patient in to the consultation room or give them a leaflet to take away with them and they can return if they want to discuss the matter.

Think about what strategies you might use to overcome these!