The Art of Active Listening...in Medicine and Life

Active listening is not necessarily easy for all of us to practice. However, active listening is at the crux of building trust and enhancing effective communication with others and can also be fostered with attention and care.

In life, I have found that the most meaningful connections that have been created have been those in which I have felt truly heard, and even further, understood. There is immense power in simply having someone listen with intention, putting aside any distractions, maintaining eye contact, not interrupting, and providing nonverbal cues such as nodding in acknowledgment or showing empathy and concern when appropriate.

Similarly, in medicine, where time is a valuable and precious commodity, it can be tempting for trainees and physicians to try to impart wisdom without first truly listening to their patients. It is known that the answer to a patient's ailments is often found in what they say. The importance of obtaining a complete and pertinent patient history is unparalleled and unable to be simply replaced with laboratory testing, imaging, and other diagnostic procedures. It was found by Platt (1947) that 74% of diagnoses can be gleaned from obtaining a patient history. His study has been further replicated through the years to show that patient history is a significant and essential part of the diagnostic process. Of note, exceptions do exist in emergent situations, those in which patients are unable to effectively communicate, and can be of variable import based upon specialty. However, it is undeniable that actively listening to a patient is often the key to finding out what ails them.

With regard to active listening, one component of doing so is not interrupting the speaker. Marvel et al. (1999) found that patients in the United States are interrupted on average after 22 seconds of speaking. Other studies, such as the one by Blau, have found that if allowed to continue uninterrupted, a patient will usually speak at most for up to 2 minutes. A question to consider is how much of a difference it can make from the perspective of a patient if they are able to share their concerns and feel truly heard.

As someone who is working on honing my active listening skills, I thought I would share some examples of techniques that we can use in both medicine and in life to better listen and communicate with others. The CDC provides an excellent guide to active listening (https://www.atsdr.cdc.gov/ceplaybook/docs/active-listening-guide-508.pdf) that shares the following suggestions: "be patient, let them lead, the power of paraphrasing, ask questions, the gift of silence, your body language, read the speaker's body language, remote engagement, and show empathy".

In conclusion, active listening lies at the heart of developing trust and human connection. By mastering the art of active listening, we can hopefully strive to create more meaningful relationships with each other both personally and professionally. Within healthcare, enhancing communication with active listening cannot only strengthen patient-physician relationships but can also result in improved health outcomes. Finally, I return to one of my favorite quotes: "I've learned that people with forget what you said, people will forget what you did, but people will never forget how you made them feel." - Maya Angelou. By listening actively and with empathy, we can ensure that we are doing our utmost towards promoting the happiness of others and making sure that they feel heard.

Wishing you all the best, always,

Sincerely,

Rupal S. Vora, M.D. MPH FACP

Founder, MedStudentCoach LLC

Associate Clinical Professor, Internal Medicine

Creighton University School of Medicine

References

Blau JN. Time to let the patient speak. BMJ. 1989;298:39.

Marvel MK, Epstein RM, Flowers K, Beckman HB. Soliciting the patient's agenda: have we improved? JAMA. 1999;281:283–287.

Platt R. Two essays on the practice of medicine. Lancet. 1947;2(6470):305-307. doi:10.1016/s0140-6736(47)90291-2 https://pubmed.ncbi.nlm.nih.gov/20257917/