When people go to the doctor's office they want the doctor to listen. Competency and a correct diagnosis are appreciated too, but more than anything, patients value doctors' silence (Richards, 1407). In addition, patients want "more and better information about their problem and the outcome, more openness about the side effects of treatment, relief of pain and emotional distress, and advice on what they can do for themselves" (Meryn, 1922). Doctors' technical role is in excellent health; it is their interpersonal role that is in intensive care. If doctors are to meet the needs of their patients they must first listen with an empathic ear and practice responsive communication. Sadly, most doctors have better handwriting than communication skills. "Effective listening empathic listening promotes growth in the listener, the one listened to, and the relationship between them" (Nichols, 1995).
Being listened to makes you feel good. The father of listening, Ralph G. Nichols said, "The most basic of all human needs is to understand and to be understood . The best way to understand people is to listen to them." Doctors' can only treat physical ailments when they chose not to listen to patients' needs. Listening is the doctors' window to what is on the inside (Bently, 56).
Susan Urba used to take a pro-active approach with her cancer patients, doing all the talking, informing them about the disease. She learned her care was better received when she focused in on her patients' needs and fears first. "Giving patients the chance to tell us what's right for them can be hard," said Urba, "but how else can we know what they truly need to feel better" (Urba, 167)?
Patients' come to the doctor because they are suffering. So, to be treated effectively, the doctor must recognize and treat the suffering not with quick advice or a bottle of pills, but by taking the time to listen to what the patient is saying. Even though doctors can never truly experience another's distress, they can do a better job at attending to their patients' needs by simply listening. Because medicine has often replaced an ear to the suffering, "physicians may inadvertently cause suffering or fail to relieve it when relief is possible" (Cassell, 24). Empathic listening is the most helpful type of listening for a sender whose message is that of suffering, sorrow and pain. Empathic listening in the doctor-patient relationship involves three elements: an active communicative emotional commitment by the listener, an acceptance that role taking is necessary, and identification with the other party (Walker, 3). Active communicative emotional commitment and role taking refers to verbal, non-verbal, physical and mental behaviors. Sheila Bently lists these listening techniques in a Nursing Homes article that is directed at caregivers for the elderly, but is applicable for doctors as well.
1. Focus your full attention on the speaker.
2. Get on the same level as the speaker. Sit or kneel by the patient.
3. Give verbal and nonverbal feedback.
4. Take the time to give some quality listening to each patient and do some relational listening.
5. Avoid giving advice that will negate the patients' feelings (i.e. "you'll be OK")
6. Let the patients talk about what he or she wants to talk about.
7. Give verbal responses that support rather than evaluate the speaker
8. Practice turn-taking.
9. Smile, be pleasant and use humor where appropriate.
The last part of empathic listening, identification with the other party, is the most important part and most difficult to practice. True identification with what the patient is going through is never possible. Doctors must put all of their energy into listening so they can try to relate with the patient as much as possible and diagnose the symptoms from the patient's perspective. The...