“When physicians listen to and communicate effectively with patients, the standard of medical practice can be raised and better treatment afforded to their patients.”[1]
This conclusion was reached decades ago by Victoria Lewin-Fetter, M.D. who coined the term “Anotodynia” – Greek for “absence of ears for pain” – to refer to the condition when a physician has difficulty listening
In today’s digital world, the importance of truly effective communication between physician and patient is often unintentionally overlooked, resulting in dissatisfaction in a patient who otherwise received excellent medical care. A recent study of 74 recorded office visits has shown that the physician interrupted the patient’s statement in 51 of them, and in only one of the 51 interrupted consultations was the patient afforded the opportunity to complete their opening statement.
The late Ernst C. Bone, M.D., a Family Physician with 60 years of experience in west central Illinois and a co-founder of the American Board of Family Medicine, advised me long ago that given the opportunity to only take a history or a physical, he would choose the history every time. When I asked why, he responded: “In the physical exam, you may not press on just the right spot – but as you sit and listen, you get the attention and confidence of your patient. You are the first person to actually listen to them. They sit there and pour out their soul and pretty soon you’ve figured out what’s wrong with them. God gave us two ears and one mouth and we should listen twice as much as we talk.” Wise advice for us all.
How should a physician best indicate to the patient that listening is actually occurring? Start by nodding at appropriate intervals and generally using positive body language, which will reassure the patient that you comprehend and care about what is being said. Look at your patient when they speak. Listen with your eyes. Sit down at their level.
Some patients may rely more on their body language and emotional tone to help convey their needs. In this situation, it is important to allow the patients to fully express themselves before asking a question. If the patient is crying or angry this allows them time to compose themselves, and gives you the opportunity to then reiterate something that was said to show the patient you have been listening carefully. As Dr. Bone told me: “If your patient knows that you care about them as a person, this will not only make you be perceived as a more pleasant person, but will also go a long way toward treating them well. Remember, the secret of care is caring.” An effective listener needs to employ not only an analytic ear, but a sympathetic one as well. Once you have listened to the patient, it is important to clearly communicate the plan of treatment to the patient by putting the explanation in terms they will readily understand. Print or write down on paper at least an outline of the treatment plan’s major points for the patient to take home, making sure all significant costs associated with the treatment are fully explained.
When a physician simply listens to the patient’s entire statement, not only will a more complete and accurate medical history result, but the patient will also perceive the physician as compassionate, caring and understanding simply because a few extra minutes were spent listening.
[1] Victoria Lewin-Fetter, M.D., Medical College of Wisconsin, Department of Psychiatry, Milwaukee, Wisconsin
