lessons learned
Listen and You Shall Hear
If you interrupt or ignore, you may miss out on important information.

By Jack Runniger, O.D.

The elderly man was waltzing down the street with a gum-chewing, peroxide blonde on his arm when he ran into his physician.

"What in the world are you doing?" exclaimed the physician.

"I'm just following your advice. You told me to be cheerful and get me a hot momma."

"No, no! What I said was that you should be careful, you have a heart murmur!"

This goes to show, as you've often learned in practice, that patients don't always listen to what you tell them. But it works both ways.

Too busy to chat

With the increased presence of managed care, healthcare practitioners just don't see themselves as having as much time to spend with each patient. But if you don't take time to listen, you may miss clues that will help in diagnosing the problem. In addition, abruptly cutting off patients' explanations doesn't do much for establishing good patient rapport.

	ILLUSTRATION BY AMY WUMMER

Study reveals . . .

A recent article in The New York Times reports on research showing that doctors interrupt patients, on average, about 20 seconds after they begin to talk.

But a new Swedish study suggests that doctors actually have little to fear from letting patients have their full say.

In the study, which was published in the British Medical Journal, 14 doctors in the outpatient clinic of University Hospital in Basel agreed to time their patients surreptitiously while allowing them to talk without interruption at the beginning of a visit.

The doctors had expected that the average statement would go on for three and a half minutes. In fact, the article stated, the average patient finished in 92 seconds, and 78% were done within two minutes. Only seven of the 335 patients hit the five-minute mark.

Falling into the same rut

I admit that I was often impatient with patients and would cut them off at the first opportunity. Particularly those who'd begin, "Last Tuesday, I had this pain in my right eye. No, maybe it was Wednesday. Let's see, I think it was right after my bridge club met, so it must've been Tuesday. At least I think it was then, because I told my husband just the other night . . ."

But by cutting off patients too soon, I often undoubtedly didn't discover their main complaint. Bob Levoy, O.D., in his excellent book, 201 Secrets of a High-Performance Optometric Practice, quotes Erwin Jay, O.D. "Whatever else you do for patients, at the very least, satisfy their chief complaint. Many of the patients we see in our offices tell us that their former doctor did not satisfy their chief complaint."

Show that you're really listening

Let's say you go to your family M.D. complaining of diarrhea. During his complete physical exam, he discovers that you also have high cholesterol. You're not going to be wildly enthusiastic about his services if he then prescribes for the cholesterol problem but ignores the diarrhea problem.

One more caveat: Don't be like the proverbial husband who repeatedly says, "Yes, Dear," to his wife's conversation without listening to a single word she says.

Listening involves more than not interrupting. You need to really listen -- and show patients with your eye contact and your attention that you're doing so.

Jack Runniger, our consulting editor, lives in Rome, GA.  He's also a past editor of OM.