Communicating with Residents

Be Heard Better

They are just little things, but they make a difference in reducing frustration for you and your residents.  We’re talking about techniques you can use every day to make communication smoother and more satisfying.

First let’s look at body position.  Standing over a resident who is sitting or in bed may feel threatening, especially if you are very close.  Research has shown that patients thought that their doctors stayed longer at the bedside than they actually did when the doctor sat down.  So try sitting down to appear less hurried. 

When people have hearing problems, as many older adults do, it is important to face the person directly and have your face at their eye level.  The shapes our lips make when speaking and expressions give residents a lot of clues to what we are saying.  It should go without saying that we should make sure hearing aides are in place, are turned on, and have fresh batteries.

Next we should speak slowly and clearly, enunciating our words precisely—slow down.  Older ears need more time to decipher what you are saying.  If you also have an accent, slowing down your speech will help older, hard-of-hearing adults understand you better.  It also helps to use gestures to supplement what you are saying.  For example, if you want the resident to sit in a chair, pat the chair or sit down to demonstrate what you would like.

By paying attention to the little details in our communications with the elderly, we can make the interchange more satisfactory for them and us!

This article was originally published in Pathways & Partners Newsletter - Issue 24.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.

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 www.pathwayshealth.org/publications.