Patient-Doctor Nonverbal Communication Says A Lot

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Patient-Doctor Nonverbal Communication Says A Lot

http://www.medicalnewstoday.com/medicalnews.php?newsid=36933

A shoulder shrug. Lack of eye contact. A hand gesture. What patients

don't say can be just as important as what they do, according to a

study of nonverbal behavior published in a January issue of the

Journal of General Internal Medicine.

According to the study by el, Ph.D., professor of

medicine at the Indiana University School of Medicine and a research

scientist at the Regenstrief Institute and the Center for

Implementing Evidence Based Practice at the Indianapolis VA Medical

Center, and colleagues from s Hopkins and Northeastern

universities and the Fetzer Institute, nonverbal behavior can be an

important diagnostic tool increasing the physician's comprehension of

words spoken or thoughts left unsaid.

On the other hand, the nonverbal behavior of the physician can

influence the patient's satisfaction with his clinic visit and affect

his compliance with the doctor's instructions.

The study on this under-recognized communication tool, entitled " The

Expression of Emotion Through Nonverbal Behavior in Medical Visits, "

was presented at the Ninth Biannual Regenstrief Conference and

appears in the supplement to the January 2006 issue of the Journal of

General Internal Medicine.

" Nonverbal behavior conveys the meaning of words, " says Dr. el,

a medical sociologist. " The way someone gestures tells you the

speaker's stance; words alone don't convey the full picture.

Nonverbal behavior can be a duplication of the words or it can

contradict what an individual is saying. " To put it more eloquently,

if the words are the musical notes on a Tchaikovsky score, then

nonverbal behavior is the interpretation of those notes. A computer

always plays the music in the same way without any nonverbal

behavior, but Jascha Heifetz would play that score differently than

Itzhak Perlman, each violinist conveying a different interpretation

of Tchaikovsky's original intent, " he said.

Nonverbal communication is a clue to the emotions underlying

feelings. Does the patient look at the physician when describing

symptoms or does he look down at his feet? Does another patient wring

her hands and refuse to meet the doctor's gaze? Either or both

patients may be exhibiting signs of humiliation or anxiety.

Does the physician repeatedly glance at her watch or answer his cell

phone? Both actions send nonverbal messages to patients, probably

messages the physician did not intend to transmit. Those scenarios

are in contrast to yet another doctor who makes eye contact and tilts

his head while the patient explains complaints of concern; that

physician appears empathetic, said Dr. el.

" From studies outside of medicine - in the business world, for

example - we know we can improve nonverbal sensitivity - altering

nonverbal cues from ourselves and others, " he said. " Our own studies

have shown that patients who are satisfied with their physicians

perceive their visits were two minutes longer than they actually were

and these patients are better at following the physician's

instructions. We also found that patients who felt their physician

was not empathetic, perceived their visit to be two minutes shortly

than it actually was. "

This study and the Regenstrief Conference where it was presented

developed from the Regenstrief Institute's focus on relationship-

centered care. " The mutual influence of patients on physicians and

physicians on patients is part of a relationship rather than

individual actions or behaviors, " said Dr. el.

In addition to Dr. el, the authors of the new study are Debra L.

Roter, Dr.Ph. of s Hopkins; Judith Hall, Ph.D. of Northeastern,

and Sluyter, Ed.D. of Fetzer. The study was funded by the

Fetzer Institute of Kalamazoo, MI.