3 Ways You Can Become a Better Clinical Listener
October 22, 2018
4 min. read
For many clinicians, the constant pressure of budgetary and time constraints results in the need to do more with less.
The result is that many try to maximize these increasingly scarce resources by packing their clinic hours with as many billable interventionsand as much documentation needed to support themas possible. This trend may at least partially account for the frequency of medical errors documented in United States medical settings.1
Although theres a role for workflow fixes such as checklists2 and prompts within electronic health records3 to improve the accuracy and efficiency of our clinical services, refocusing on simple and time-tested basics is also necessary.
Start with Listening
When it comes to doing more with less, it doesnt get much simpler than listening to your patients. To paraphrase Dr. William Osler, If you listen to the patient, they will tell you their diagnosis.5 While this statement originally applied to making an accurate diagnosis based on disease etiology, this timeless wisdom also applies to clinicians across all areas of medical care, speaking to the need to develop and refine the skills of listening for clinically relevant information.
Three Things to Think About
Want to become a better clinical listener for your patients? Start with these three steps:
1. Let Them Talk!
Data suggests that most people visiting a clinician have an average of eleven seconds of talk time6 before they are interrupted. Even as a health care provider, you have probably had the experience yourself of waiting a long time to see a clinician. And you may have also directly experienced the difficulty of getting your own story out.
Start challenging yourself to give your patients two minutes of uninterrupted talking time. Avoid asking clarifying questions early on because these can cause a patient to shut down and stop talking. Additionally, ensure that your active listening practices arent distracting your patients. While its good to let your patient know that you are engaged in the conversation, theres such a thing as too much eye contact, head nodding, and vocalizations such as uh huh. Your patient may begin to feel self-conscious or think you are looking for an opportunity to jump in.
Although many clinicians express the concern that their patients will talk so much that they wont have time to accomplish what needs to be done during the appointment, a little extra time up front can often save a lot of time later and even help you build a more effective therapeutic alliance with your patients.
2. Be Present
When youre working with patients, you always have a number of details to process, both inside and outside the treatment room. One such major interruption is documentation.
Try taking notes when youre finished with the visit instead of while you speak with your patients. You might find that the additional uninterrupted time during the visit results in extra time at the end of the session for documentation.
If this option doesnt work for you, you can still improve your presence by looking up frequently from your computer or notepad. One good way to make sure youre doing this is by consciously making eye contact throughout the visit.
3. Context Matters
How many times have you come across two people with a completely identical diagnosis but completely different needs and outcomes based on subtle differences? Without careful listening, you might miss these small but important details.
While the content of your conversations is important, you should also be taking in valuable context as you are listening. Clues that might inspire you to dive a little deeper include:
As you listen, strive to understand whether your patients might have unique needs9 based on the social determinants of health.
Want more information on creating, cultivating, and leveraging patient relationships? Make sure to check out the many courses on patient engagement, connection, and listening available through Medbridge, such as:
Below, watch Rebecca Hunting Pompon demonstrate summarization as a component of active listening in a short clip from her MedBridge course, Building Counseling Skills: Active Listening, Empathy, and Gathering Information.
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