Monday, June 11, 2012

What You Say Without Speaking

It’s estimated that up to 93% of all communication exchanges are nonverbal.  That means facial expressions, gestures and the way we stand all say something—of which we are often unaware.

For nearly 20 years medical schools have been required to teach communication skills, mainly due to research that links physician-patient communication with patient satisfaction and health care outcomes.  They offer everything from courses on lectures, video recording and self-assessments.

But, writes New York Times columnist Pauline Chen, few schools offer courses on facial expressions and body language, “despite a growing body of research suggesting that nonverbal communication may be as important as verbal communication. Important nonverbal cues in physician-patient interactions can include subtle body gestures, body positions, eye contact, facial expressions, and touch.”

One of the most powerful tools we have is eye contact, and how much we are willing to give to patients.  It tells patients they are being listened to (a great satisfier in patient interactions).  Do you nod to let them know they have your full attention, or does it look like you are a million miles away while they tell their story?

A recent study in the Journal of General Internal Medicine (JGIM) found that black physicians used positive nonverbal cues better than white physicians, although they sometimes gave contradictory nonverbal signals.  A 1994 study had shown that women physicians tend to give male patients conflicting nonverbal cues, like smiling while speaking in an anxious tone of voice.

Experts suggest physicians note their body language: Do you cross your arms, look away or make notes while the patient is speaking?  Or do you look engaged, touch the patient’s hand, and appear unrushed? Experts say nothing is more powerful than imagining yourself in the patient’s place to put things in perspective.  

This article was originally published in Pathways Physician & Health Professional Bulletin - Issue 23.  To download this issue in PDF format, or past issues, visit our newsletter archives online at

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