Ten Steps to Better Listening

1. Realize the need for concentration. The first step toward developing good habits is to discard the myth that listening is effortless. Since we can speak at a much slower rate than we hear, listening alertness is easily compromised. Pay attention to stimuli other than just words to bridge the gap between thought speed and listening speed.

2. Avoid barriers to good listening. Distractions, reacting to emotion-laden words, daydreaming,
narrowing on specific facts, impatience, inability to deal with complaints and projecting negative feelings onto the speaker are typical ways the listener can sabotage interpersonal communications.

3. Pay attention to both verbal and nonverbal messages. Look for cues of what is really being communicated. Be aware of the voice its sound, pitch and speed-and notice the speaker’s body
language. Is there eye contact? What do the facial expressions and gestures tell you? Does a particular subject, like a root canal, bring about an unusual reaction?

4. Make the environment conducive to listening. When you are discussing treatment plans or obtaining diagnostic data, patients should be sitting up, not lying down. Eye level communication will add to a good patient relationship. Your office is the best place to explain situations requiring a series of procedures and visits.

5. Display attentiveness. Assume a relaxed posture, leaning slightly forward, not fidgeting or playing with your hands. Maintain eye contact-this should be natural, not a stare.

6. Build in listening time. Allow a few.minutes for discussion before and after any examination or operation. Many procedures hinder spontaneous communication.

7. Choose your questioning technique carefully. Close-ended questions limit patient responses. For example, “Do you have pain at night?” does not elicit the same response as the open-ended question, “When do you usually have pain?”

8. Use encouraging reinforcements. These can be verbal. For example: “Yes, go on, I understand,” or nonverbal, as in nodding, smiling and tilting your head. When a patient has difficulty expressing concerns, these techniques can help ease the tension.

9. Ask for feedback. If a patient is emotionally overwhelmed by what you are saying, listening will be decreased. Having a patient restate information will thwart, “but doctor, you didn’t tell me,” and potential misunderstandings.

10. Practice total listening. Listen between the lines to what is being said, how it is being said and why it is being said.