Nonverbal communication and the doctor-patient relationship

When we talk about a medical language barrier, we usually mean one of two things: either a healthcare provider and a patient who don’t speak the same language or the problem of medical jargon making health-related information unclear. But a recent article from Omnia Health serves as a reminder that verbal language isn’t the only thing that can keep patients and clinicians from understanding one another. Although it’s hard to get an exact figure, a number of studies over the years have found that 70-93% of human communication is nonverbal. So why don’t we think of it more often when it comes to interactions between healthcare providers and patients? The Omnia Health article isn’t the only one that’s been written on the subject, and in fact, it cites more than a dozen recent studies that have also helped confirm the importance of nonverbal communication. These findings can help healthcare providers better communicate with - and understand - their patients. Here are some examples of how: ● empathy - Fatima Abbas, the article’s author, cites a study that shows empathy from doctors has a positive impact on patients. This makes sense. After all, if someone reacts to your health concerns with total indifference, you might not be as motivated to share important details with them, or to listen to what they have to say. ● eye contact - One way to show empathy, as well as a general sense that you’re paying attention and care about what someone has to say, is maintaining eye contact. But as this article from MedPro Group points out, even doctors who are aware of the impact of eye contact may sometimes fail at maintaining it. Electronic health records are often to blame; during a consultation, they can make doctors look at their computer screen, type while the patient is talking, or even turn their back on a patient, depending on where their computer is located. The site suggests that doctors explain in advance why they may have to do these things, or, if possible, simply not use the computer until the end of the consultation. A scribe may also be a solution. ● body language - Body language is an important part of patient-provider communication in two notable ways. First, it can let healthcare providers show patients that they’re listening, invested in what the patient has to say, and trustworthy. Medical communication specialists from Healthcare Communication Matters advise clinicians to use “open body language” during consultations. This includes nodding to acknowledge that you’re listening, smiling when appropriate, and facing the patient as often as possible. The other main way body language is important during consultations is in helping to better understand patients. Abbas and others who’ve written on the subject point out that body language can be an important way for healthcare providers to understand things that patients might be too polite or intimidated to say. The Healthcare Communication Matters Website features a helpful illustrated guide to common body language and some of the things it might mean. That said, it’s important to keep in mind that some cultures may use certain gestures differently, or not at all. For healthcare providers who treat a large number of people from a different cultural background than their own, cultural training courses could be helpful, or even a must.

● cadence - Sometimes, it’s not just the words you use, but how you use them. Accent specialist Ted Lapekas explains, “As native speakers we listen to the ‘music’ of the language: the pauses and stressed words are more key to our understanding than the word’s pronunciation. Even if the speaker gets all the words correct but delivers it with unfamiliar ‘music’ the native speaker will miss the correct meaning.” For a conversation between non-native speakers of a language, this issue can be even more difficult to overcome. One tip for reducing an accent and making words easier to understand is to slow down (or to politely ask the other person to slow down). Another is, if possible, to write down or ask the other person to write down, any words that still aren’t clear. These tips may mean taking a bit more time in a consultation, but the end result could literally be life-saving. ● personal space - We all have a personal “bubble” that we don’t want people to enter. This can vary by culture or even by individuals. Healthcare Communication Matters advises clinicians to be aware of how a patient reacts to space. If they come closer, it may be that the clinician has placed themself a bit too far to be comforting. If a patient moves away a bit, this could mean that the clinician has unwittingly invaded their personal bubble and should subtly move back a few inches. The right space can make patients feel more comfortable and also, the site points out, better able to focus on any information they’re being given. Realizing how important nonverbal communication is for doctors and patients, and how it works on so many levels, may be intimidating. Fortunately, a lot of it is automatic, or can be easily changed. And the results could be a dramatic improvement in a doctor/patient relationship, not to mention patient health.

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