11 Seconds.

by Burl Stamp

11 Seconds.

by Burl Stamp

by Burl Stamp

That’s how long, on average, a doctor will listen to a patient tell his story before interrupting.

According to a recent study published in the Journal of General Internal Medicine, we still have far to go in improving one of the most important communication skills in health care: active listening. This study, which was also reported in the July 22 issue of Newsweek, studied clinical encounters between patients and physicians.

The team of scientists learned doctors only spent an average of 11 seconds listening to a patient describe their reasons for visiting before interrupting. According to the article, the team only counted how long it took a doctor to interrupt if the doctor first asked, for example, “What can I do for you today?” or “Tell me what brings you in today,” allowing the patients to set the agenda of the conversation. The study also found that only 36 percent of doctors asked questions that invited patients to direct the focus of the conversation, and specialists allowed even less time than primary care doctors.

It’s true that some interruptions, such as those asking clarifying questions, can be helpful. However, study author Naykky Singh Ospina cautions, interrupting at an early stage in the encounter, even to clarify or focus, is unlikely to benefit either patient or physician.

In defense of physicians and other care professionals, listening is hard work. To improve active listening and the overall effectiveness of communication with patients, Stamp&Chase recommends that organizations start with the following truths:

Awareness is Job 1

Clearly stating that improved listening is a priority sounds obvious, but if care professionals don’t become more aware of their own behavior, no other intervention will take hold. Consistently tracking, reporting and discussing progress on the key HCAHPS question, “During this hospital stay, how often did doctors (or nurses) listen carefully to you?” is a good way to begin increasing self-awareness.

Listening is an acquired skill

Most individuals believe they already hear what patients are saying, so simply telling staff to “listen better” is unlikely to produce improved interactions. Skill-building through workshops, eLearning modules and/or individual feedback should focus on the basic best practices first: sitting down, making better eye contact, and moving away from distractions like the computer or phone screen. Once these are established, focusing on questions that encourage patient explanations takes conversations to a higher, mutually beneficial place:

  • “What concerns or worries you most?”
  • “What parts of your care plan are still unclear or confusing?”
  • “How are you feeling about your condition and care at this point?”

Finally, reassuring patients with declarations such as, “I want to be sure I’ve heard and understand all of your questions and concerns,” clarifies that listening is a priority. It also gives patients permission to push back when they feel they are not being heard.

Listening is in the eye of the beholder

A conversation where one patient feels heard may make another individual feel ignored. To assess whether a patient truly feels heard, caregivers should “listen” to non-verbal signals as closely as they listen to the actual words a patient speaks. Closing conversations with reassuring questions such as, “What other questions or concerns do you have that we haven’t talked about?” (rather than the rhetorical, “Do you have any other questions?”) helps ensure that each patient leaves a conversation with both the understanding and reassurance they need.

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