Is listening part of your practice culture?
A CRITICAL COMPONENT of personalized patient care is cultivating the art of listening. Listening is key to all communication, without the ability to listen effectively messages are easily misunderstood - communication breaks down and the sender of the message can easily become frustrated or irritated.
Listening is not the same as hearing!
Being privileged to be a part of few TMJD discussion group forums, I frequently encounter posts like the following:
"I have found solution to my TMD and facial pain in meditation. I need to do more meditation to find the doctor. The doctor who listens and grasps the essence."
"My doctor says I am imagining my symptoms...because of the symptoms that comes with TMJ, I have stress and anxiety. It's awful and definitely not imagined!"
"Some doctors will prescribe anti-depressants and anti-anxiety meds because they think it is mental..."
"Some doctors will prescribe anti-depressants and anti-anxiety meds because they think it is mental..."
"If a patient is following YOUR protocol....and has raised acute pain from your splints/orthotics....something is NOT right!! Please doctors don't blame the patient for non compliance. We are the ones that have to try and wear these (at times non measured) appliances.....and are in agony....not you....For the love of all that is good in this universe....please listen to your patients!!!"
"...please, oh please don't tell your patient that they are just stressed and need to relax. Anxiety and depression can be a factor in the process, but It isn't an excuse when you are having trouble helping your patient."
"...we become our own doctors when it comes to tmj so plllllease listen to your patient you never know it might help them.."
"Well that was a waste of time. He didn't even examine me, nor give me vitamin D. Spent 30 minutes saying it was all psychosomatic & that he didn't believe teeth could ever cause such problems."
"I am currently in severe headache with TMJ. God Please Help me. meds are useless and my doc keeps prescribing them to me....he doesn't get it..."
"I have been dealing with TMJ and ear problems for about 7 years. I've been to so many doctors and they all have different opinions and only hear themselves. I think they are all full of themselves..."
Unfortunately I could go on with these type of comments, and it saddens me to see so many professionals lacking the ability of effective listening.
Effective listening requires concentration and the use of your other senses - not just hearing the words spoken.
Listening is not the same as hearing and in order to listen effectively you need to use more than just your ears.
The 5 Principles of Listening
A good listener will listen not only to what is being said, but also to what is left unsaid or only partially said.
Effective listening involves observing body language and noticing inconsistencies between verbal and non-verbal messages.
1. Undivided Attention
- Open communication through active listening is the keystone of good health care. Active listening is a therapeutic technique that establishes trust in a health care professional-patient relationship. To begin, give the patient your undivided attention and refrain from interrupting until he is finished speaking. Ignore distracting thoughts and avoid outside distractions, including environmental factors and other people's conversations. Focus on the person to show he has your undivided attention.
2. Body Language
- Body language is just as important as what you say during a conversation. Maintain eye contact and nod at appropriate times to show you are actively engaged in what your patient has to say. Avoid crossing your arms and keep an open posture to show you are open to communication. Avoid grimaces and frowns, which can discourage patients from sharing personal information due to embarrassment. Oftentimes, patients are already scared and uncomfortable when coming to an office or medical facility. By simply touching her hand, you can encourage her to share more details about her condition.
3. Acknowledgement
- After listening to what your patient has to say, paraphrase her comments to verify your understanding of the situation. Not only will this clear up any misconceptions you have, but it also helps to validate the patient's feelings about what she is going through. Clarify important details by asking if you have a thorough understanding of what he is saying and feeling. Ask open-ended questions to help him elaborate on key aspects you want to take note of or record in his chart. As an active listener, the most important goal is to understand what your patient is saying.
4. Nonjudgmental Attitude
- Once you have a thorough understanding of your patient's message, withhold judgment, even if you disagree. Avoid interrupting with counterarguments, which stifle conversation and can ruin trust. Critical comments will only frustrate the patient and limit your understanding of his message. As a medical professional, it is your job to provide care and understanding without judgment of your patient's choices and experiences.
5. Response
- Active listening is based on honesty, trust and understanding. Provide your professional opinion of the situation, but don't talk down to the patient just because she doesn't have the same medical training as you have. By clarifying the patient's message, you can help him explore other points of view. Show your empathy for the patient by treating her with respect. Always treat patients the way you would want to be treated if the situation were reversed.
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