Listen with an open mind to what the speaker has to say.

–Dr. Apeksha Kakkar

Over the next 10 weeks, Glocal Academy will present a series of articles on effective listening tips. This is the first of the series of 10 articles.

Listening skills constitute an essential part of practicing medicine. Effective listening stems from the need for treating each human being with equal respect. Not doing so, exposes the medical field to abundant malpractice suits which in turn increases the burden of document work on physicians. 

As listening is a habit, we can practice and incorporate good listening tips (image below) to improve our people skills. Listening with an open mind can in fact be the decisive factor that influences a patient’s choice between two doctors.

Often impatience due to time constraints and/or heavy workload leads doctors to interrupt the patient prematurely or have the diagnosis ready in mind (anchoring bias[1]) even before the patient can complete their history. For composite patient care, a clinician should have a thorough understanding of the subject as well as the ability to interact with patients in a manner that encourages them to share their troubles without hesitation. To facilitate this process, the doctor needs to first get rid of any preconceived notions and treat each patient encounter as a fresh one. While clinical experience aids in the application of clinical knowledge, attention to detail helps us in achieving mastery over the craft of medicine.

For example, when an elderly patient comes to you with a complaint of some bruise or body aches, don’t jump to the conclusion that it is attributable to old age. Listen carefully and compare the wounds to the history because inconsistencies in the two can point us towards elderly abuse or mistreatment.

As a result of ineffective listening, the patient will be dissatisfied with the treatment and the original complaint will remain unresolved. Healing emphasizes on relieving the patient of their discomfort. For this, we need to listen to the patient’s story without any bias.  In high school, I came down with high fever and my paediatrician was out of town. Thus, I had to visit a new doctor and while his credentials and experience were top-notch, he neither let me complete what I was saying about the associated symptoms nor did he bother to elaborate about his initial impressions. I was so put-off by the rude behavior that I instantly knew I will not follow-up with him. I also refused to take any treatment he prescribed, except the Paracetamol (Tylenol) that my mother had already started.

The interesting thing about sickness is that we revert to a more primitive form of behavior where we assume a sick role and want someone to take care of us. I simply needed a compassionate person to listen to me and tell me that I will be fine. Doctors need to pay attention to the physical as well as psychological aspects of a disease.  The feeling of being heard is therapeutic and strengthens the trust between a doctor and patient. This leads to overall satisfaction at both ends and better outcomes, which is the ultimate goal of healthcare.

Reflective Questions:

  • Have you ever missed a diagnosis because you didn’t let the patient finish what he had to say or had a bias in your mind that lead you towards the wrong differential diagnosis?
  • What are your tips for successfully incorporating this strategy into a busy practice?

[1]

Anchoring Bias: 

– A bias is defined by the Oxford dictionary as an inclination or prejudice against a person/group, especially in a way considered to be unfair.

– Anchor in layman terms is an object dropped in water to prevent further movement of the boat.

– In medical or financial setup, anchoring bias refers to fixating on initial impressions or the first information one finds when making decisions. 


About Author

Dr. Apeksha Kakkar

Dr. Apeksha Kakkar; M.B.B.S, ECFMG certified
Grant Government Medical College & Sir J.J. Group of Hospitals, Mumbai, India
As a medical graduate from one of the leading medical colleges in India, Grant Medical College (#GMCite), I live in ‘The Pursuit of Excellence’. Our medical school motto “Mens sana in corpore sano“, which translates into “a healthy mind in a healthy body”, is the core principle underlying our medical education. I aspire to pursue further education in the United States of America and apply the learned skills to advance healthcare in developing countries. Writing (blogger, amateur poet), personal growth, spirituality, patient-centered care and medical education, are some things I am passionate about. An interesting debate topic according to me is ‘ The role of religion in influencing sociopolitical scenario’. On a lighter note, I like to watch television shows and movies, listen to a wide variety of music and cooking for my family. ‘Extravagant mind, simple living’ is my go-to ‘mantra’ in life!
 
Blog link: https://thelodestarblog.wordpress.com/;
Website link: www.linkedin.com/in/apeksha-kakkar-86339785

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