The Four Habits Coding Scheme

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"I see one habit, where's the other three?"

The Four Habits Coding Scheme (or 4HCS) is a model that tries to directly measure health care communications. The four habits are investing in the beginning ("Please don't ask me for pain meds"), eliciting the patient's perspective ("I want Dilaudid"), demonstrating empathy ("Yeah... No Dilaudid," and investing in the end ("Don't hesitate to leave AMA"). A recent study in the Journal of Hospital Medicine showed that HCAHPS scores do not correlate with 4HCS.[1]

Related Reading


  1. Do HCAHPS doctor communication scores reflect the communication skills of the attending on record? (Journal of Hospital Medicine)

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