Your body language speaks loudly
Nonverbal communication makes patient more comfortable
By Carolyn Rogers
Physicians honing their verbal skills in communicating with patients need to pay attention to their body language, too. Experts say doctors who have mastered nonverbal communication are more comfortable with their patients and their patients are more comfortable with them. This makes 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 immensemuch 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," Damsey says, "an awareness of the nonverbal cues youre sending is essential.
"If the body language isnt right, patients often dont hear what the physician is saying."
While much of nonverbal communication is unconscious, it is possible to be more deliberate and improve the nonverbal cues that you send. But if you cant 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 theyve got a fantastic start," says Ramsey.
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 handssays 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 "Im 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, its an obstacle that takes extra visit time.
F is for forward lean. Lean forward but ever so slightly so that youre not in the other persons body space. Whether youre standing or sitting, this forward lean tells the patient "Im trying to get closer because I really want to hear what you have to say."
T is for touch. Its 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 patients 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, its 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 patients 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. Youre not necessarily nodding in agreement, but rather as a nonverbal way of saying "I hear you I understand what youre 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 offsomething many patients find offensive. But if you nod, the patient will speed up and get their message across more quickly because they know that youre understanding them.
Another nonverbal cue that Damsey finds particularly helpful is, during a key moment, to place your hand briefly on your heart.
"Patients need to know that physicians are sincere," Damsey says. "When patients asks questions that indicate they dont know if they can trust what the physician is telling them, this simple nonverbal cue can help convey the doctors sincerity. By putting a hand to your heart, youre saying I believe in this, and I think you can believe in it, too. I wouldnt be telling you this if I didnt believe in it 100 percentfrom the heart. Its very simple and very effective."
Some nonverbal cues to avoid include:
Physicians need to teach their staff some nonverbal communication skills as well, Damsey believes.
"Its very common to walk into a doctors office and your first contact is a receptionist who has her head down, talking on the phone. Shes not recepting. Even if shes unable to greet the patient, instruct her to smile, wave her hand or put her finger up to indicate Ill 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 shouldnt take long to make these simple nonverbal signals something thats practice-wide. Your next staff meeting is a good place to start."
What are the ultimate benefits of improving your nonverbal skills?
While you may not always associate nonverbal communication with productivity or the bottom line, Damsey says, it does have a direct effect.
Communicate welcomes suggestions about future topics for the column on patient-physician communications. Send your suggestions to the Bulletin, at AAOS, 6300 N. River Rd., Rosemont, Ill. 60018. Fax (847) 823-8026.