"When physicians listen to and communicate effectively with patients, the standard of medical practice can be raised and better treatment afforded to their patients."

 

This conclusion was reached decades ago by Victoria Lewin-Fetter, MD, who coined the term "Anotodynia" (Greek: absence of ears for pain) to refer to the condition when a physician has difficulty listening. 

 

In our modern world of sound bites and 140 character tweets, the importance of truly effective communication between the physician and patient is often overlooked. This oversight, albeit unintentional, can cause dissatisfaction in a patient who has otherwise received excellent medical care. 

 

One study of 74 recorded office visits has shown that the physician interrupted the patient's statement in 51 of them. In fact, in only one of the 51 interrupted consultations was the patient afforded the opportunity to complete his/her opening statement. 

 

A board certified family physician who has been in practice for over 60 years told me recently that given the opportunity to take a history or a physical, he would choose the history every time. Why? "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."

 

How should the physician best indicate to the patient that listening is actually occurring? Start by nodding at appropriate intervals and generally using positive body language. This will reassure the patient that the listener comprehends and cares about what is being said. Look at your patient when they speak. Listen with your eyes. Sit down at their level.

 

Some patients may not be able to adequately express themselves through their words alone. Instead, they may rely more on their body language and emotional tone to help convey their needs. In these situations, it is important to allow the patients to fully express themselves before asking questions. If someone is crying or angry, allow them to compose themselves. After they have become more calm, ask them to reiterate something that was said – it will show you have been listening carefully. As that same family physician 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 the physician has 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. Write down on paper at least an outline of the treatment plan's major points for the patient to take home, making sure that all significant costs associated with the treatment are fully explained to the patient. Finally, when discussing any complications that may arise from a particular treatment, make sure to avoid ambiguous terms such as "probably," "sometimes," and "unlikely." Instead, use percentages: "You have a 10 percent chance of post-operative complication." Then, discuss the possible complications with the patient, document your discussion, and have both the patient's and physician's initials on that written documentation. 

 

If a physician will simply listen 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.