Listening skills in health interactions

Listening skills are useful and very important in health interactions. Stewart (1995) noted that when patients are encouraged by their healthcare providers to complete their statement of concerns they feel more comfortable with the interaction and relationship and reveal important medical information.

There are at least two very good reasons for letting the patients go first and have a minute or two of relatively uninterrupted story at the very beginning of the consultation by the listener.

Only the patient knows the reason(s) why they have come to see the doctor. Therefore the patient’s agenda should be sought out first. The natural way to do this is to let the patients go first. The patient’s reason(s) is never just a symptom but also their ideas about the symptom, their concerns caused by the symptom and their expectations. If a doctor looks at his biomedical agenda too soon he may never discover what the patient really thinks and feels, what really worries them or what they are really expecting.
The doctor may gain much more valuable information by consciously delaying making their first hypothesis for just two or three minutes while he listens to the patients’ information.

In other words, a patient’s narrative can show a more complete picture. This is of help in the exploration of both the disease and illness frameworks with the potential for better understanding and more effective diagnostic reasoning. Listening also gives the care-professional time to think and not just ask the next question. Letting the patients go first immediately sets a pattern of patient participation. Afterall this might even time saving. This also applies to follow-up visits, which have more in common with new consultations than is often believed.[1]

Effective interaction between patients and clinicians not only decreases unnecessary stress and the length of the treatment process but also helps to build a trusting relationship and improves patients’ awareness of their health condition. Obtaining the patients’ narrative is a valuable means of communication with patients that enables clinicians to listen to the patients, create a positive atmosphere to pass on relevant health information, and to promote health self-management. [2]

Listening “speaks”

Starting of with the patient’s story and the doctor’s attentive listening to that story is extremely important from the very beginning of the consultation and imparts two important messages to the patient:

It reassures the patient, taking away any uncertainty about the interest of the doctor in what they are saying and thus in their problem and in themselves. From the very beginning of the consultation the doctor’s attentive listening makes the patient feel good, and makes them feel that this doctor is indeed the doctor they expected. It is not what the care-professional says but rather how they make a patient feel that is important when they start gathering information.
It encourages patients to continue with their account, taking away any uncertainty about their life, body and future. [3]
Narratives convey feelings and communicate ideas that the listener needs to hear. As such, they make powerful tools in all endeavours of human interaction. Modern medicine needs to learn to integrate the compassion and empathy gleaned from a patient’s narrative with the knowledge and integrity needed to alleviate the patient’s suffering and pain.[4]

[1]Medics on the move, Pronounciation Manual, 2011

[2] Salevati S. The Role of Narrative in Patient-Clinician Communication, School of Interactive Arts and Technology, SFU

[3]Medics on the move, Pronounciation Manual, 2011

[4]Langer N., Ribarich M. Using Narratives in Healthcare Communication, Educational Gerontology, volume 35, issue1, 2008

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