There are several general characteristics that affect communication between doctor and patient. These include:
• poor past relationships and experiences leading to unresolved interpersonal conflict, e.g. an incorrect diagnosis or poor treatment outcome and indifferent compliance in following treatment or paying accounts
• personal differences, openly expressed, which may create subtle barriers, including differences in age, sex, religion, culture, social status and doctor/patient roles (occasionally influenced by political factors)
• the communication skills of doctor and patient, both as the sender and receiver of messages
• the personal honesty and integrity of both parties in dealing with difficult messages
• psychosocial problems that will establish barriers, e.g. psychiatric illness or speech impediments
• familiarity between patient and doctor, e.g. friends or relatives
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