NAME: Tammy Lin

OCCUPATION: Physician

Effective listening in medical contexts means give-and-take between doctors and patients with the goal of promoting better health and wellness. As a physician specializing in internal medicine, I think of this daily. For my patients’ maximum therapeutic benefit, I must listen closely to them—and they must also listen to me. The answers to patients’ questions often lie in their stories, and for me to make an accurate diagnosis, I must actively listen and elicit the necessary information.

I like to think of listening to my patients as a process of discovery. Coming up with an accurate diagnosis and devising an effective treatment plan can be a puzzle. I have to search for as much information as possible about patients’ health—such as what they eat and drink, what drugs (prescription and nonprescription) they take, what toxins they may have been exposed to, and what exercise they do (or don’t do). This might seem like a simple question-and-answer method, but there are often roadblocks. For example, some patients are incredibly anxious when speaking with a doctor or are too embarrassed to give truthful answers (particularly about issues like diet or mental health). Still other patients seem to withhold information to see how “good” I am at figuring things out on my own. In all of these circumstances, it’s up to me to put the patient at ease by opening with generally “safe” questions and easing my way into more difficult topics.

Knowing how to listen is an essential skill that allows me to do my job. With every patient, I focus on giving my full attention, not interrupting, and remaining open to whatever the patient would like to tell me. Nonetheless, my patients also have an obligation to be engaged listeners and honest participants in their own health care. Clearly, it’s important that they listen in order to understand the options they have for treatment, and I encourage them to paraphrase the information I’ve shared. (When patients paraphrase in their own words, it shows that they comprehend what I’ve said. Asking them to repeat my exact words is not particularly helpful!) I also welcome and encourage questions, letting patients know that no question is too silly or simple. If I’m giving complex instructions (like information on taking a medication at a specific time of day), I either encourage patients to take notes or provide them with written materials they can bring home. Sometimes the process of writing down the information helps patients process and absorb it. Because patients may be distracted during their visit, they may not fully understand or remember what I tell them.

A particularly difficult listening challenge involves sharing and hearing bad news—like the diagnosis of a life-changing or potentially terminal illness. I always anticipate the patients’ shock and watch their nonverbal communication to gauge how much information they can absorb at the moment—and what needs to be saved for later. It’s simply not beneficial to spew off facts and treatment options to someone who is flushed, breathing rapidly, or crying with her head in her hands. Similarly, I hope that my patients are also monitoring my nonverbal cues in such situations. If I tell a patient that he has type 2 diabetes, for example, I use a serious tone of voice and somber facial expression while maintaining direct eye contact. It’s essential that the patient sees me taking this diagnosis seriously so that he is aware of the seriousness of the lifestyle changes he’ll need to implement.

The next time you see your doctor, remember that it’s a mutually beneficial listening process. For a physician to arrive at an accurate diagnosis and come up with a successful treatment plan, the patient must be prepared to share all of the information related to his or her health situation (for example, current medications, recent life changes, and so on). Before your next visit, write down your questions and don’t be afraid to ask about anything you don’t understand. Be prepared to listen to your doctor, and help your doctor listen to you.