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Saturday, February 16, 2002

Your body language speaks loudly: Nonverbal communication makes patient more comfortable

By Carolyn Rogers

Physicians honing their verbal communication skills with patients should pay special attention to their body language as well. Experts say doctors who have mastered nonverbal communication are more comfortable with their patients and their patients are more comfortable with them. As a result, office visits flow more smoothly and efficiently.

"Between 55 and 70 percent of your communication is nonverbal," says Joan Damsey, founder of Damsey & Associates, Ltd., a practice management firm in Norfolk, Va. "Only about 7 percent is actual words used and the rest is tone of voice, etc."

The effect of nonverbal communication on the patient-physician interaction, therefore, is immense - much greater than most physicians realize, according to Damsey. "If you want your patients to trust you, if you want your patients to come back, if you want your patients to tell their friends and coworkers and neighbors about you," she says, "an awareness of the nonverbal cues you're sending is essential.

"If the body language isn't right, patients often don't hear what the physician is saying."

Soften your nonverbal cues

While much nonverbal communication is unconscious, it is possible to be more deliberate and improve the nonverbal cues that you send. But if you can't fit a course on body language into your schedule, Damsey has an easy, one-word lesson.

"What I teach residents is if they can remember the word 'SOFTEN' they've got a fantastic start," she says.

S is for smile. A smile helps set patients at ease and generates positive feelings about you and your practice. This in turn breaks down barriers so you can uncover issues more quickly and openly.

O is for open posture. Open posture-which means no crossed legs, arms or hands-says you are approachable and willing to interact. Arms drawn across your chest, on the other hand, can be intimidating or even condescending to patients. It suggests "I'm closed to what you have to say," which often makes patients feel they must explain themselves extensively just to get past your barrier. Or they might put up their own defensive barrier in return. Either way, it's an obstacle that takes extra visit time.

F is for forward lean. Lean forward, but ever so slightly, so that you're not in the other person's body space. Whether you're standing or sitting, this forward lean tells the patient "I'm trying to get closer because I really want to hear what you have to say."

T is for touch. It's extremely important to touch patients. As you walk into the room, shake hands with the patient in a warm and friendly manner. Or, if the patient is over 70 or so, perhaps a tap on the shoulder might be more appropriate. But by shaking hands with the patient, the doctor not only sends a friendly nonverbal message, he or she can also learn lot about the patient's psychological state. Is the hand warm, cold, jittery, sweaty? All are clues that may save you time.

E is for eye contact. Eye contact is probably the most important nonverbal communicator after smiling. Eye contact conveys that you are paying attention to the individual, not being distracted by your notes or something else on your mind. However, if eye contact is maintained 100 percent of the time, it's bound to be uncomfortable for both the communicator and the receiver. So, try to maintain eye contact about 80 percent of the time. Use caution, though, and do not gaze directly into the patient's pupils, but rather within a 3- to 4-inch orbit of the eyes. The point is to help the patient feel you are connecting with them, not staring them down.

N is for nod. As your patient speaks, it is important to nod occasionally. You're not necessarily nodding in agreement, but rather as a nonverbal way of saying "I hear you…I understand what you're saying." Nodding also encourages the patient to move along with their story. Very often physicians have heard the same story five times already that day, and they cut patients off-something many patients find offensive. But if you nod, the patient will speed up and get their message across more quickly because they know that you understand them.

Another nonverbal cue that Damsey finds particularly helpful is, during a key moment, to place your hand briefly on your heart.

"This may seem hokey, but patients need to know that physicians are sincere," she says. "When patients ask questions that indicate they don't know if they can trust what the physician is telling them, this simple nonverbal cue can help convey the doctor's sincerity. By putting a hand to your heart, you're saying 'I believe in this, and I think you can believe in it, too. I wouldn't be telling you this if I didn't believe in it 100 percent-from the heart.' It's very simple and very effective."

Cues to Avoid

Some nonverbal cues to avoid include:

Staff should also be aware

Physicians need to teach their staff some nonverbal communication skills as well, Damsey believes. "It's very common to walk into a doctor's office and your first contact is a receptionist who has her head down, talking on the phone. She's not 'recepting.' Even if she's unable to greet the patient, instruct her to smile, wave her hand or put her finger up to indicate 'I'll be with you in a minute.' These small nonverbal cues can go a long way toward making a good impression."

Staff can put the SOFTEN nonverbal signals to work, as well. "It shouldn't take long to make these simple nonverbal signals something that's practice-wide. Your next staff meeting is a good place to start, " Damsey adds. What are the ultimate benefits of improving your nonverbal skills? While you may not always associate nonverbal communication with productivity or the bottom line, Joan Damsey says, it does have a direct effect.

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Last modified 11/February/2002