Listening doctors, healthy patients

If doctors and nurses listened more to their patients, it would make a “huge difference” to getting diagnoses correct; particularly if that patient is elderly or of a non-English speaking background.

The study, by linguistics experts at the University of Technology in Sydney, hit upon the idea which experts say could dramatically improve patient care.

The study also shows more can be done to get medical clinicians communicating better with each other.

Researchers say it can be a long wait to be seen in a busy hospital emergency department, and the pressure is on staff to ensure patients are treated quickly and moved on to “make room” for others to take their beds.

Professor Diana Slade, who specialises in applied linguistics at the University of Technology in Sydney, says her team covered 1,000 hours of direct observation of patients communicating with medical clinicians in several New South Wales and ACT hospitals.

“We taped 82 patients through their journey. We didn’t hear one example of a doctor saying ‘tell me what you think is wrong with you’,” Professor Slade says.

“If you start off with that question then you’re much more likely to actually find out what the patient is worried about, what they’re anxious about and therefore what their problem is,” she adds.

Professor Slade says if doctors and nurses concentrated on establishing and building up rapport and empathy with the patient by listening to the patient’s story, it would alleviate the patient’s anxiety, and health professionals will then  reach an effective diagnosis much more quickly than if they just focused on the medical.

The study showed there were 225 different interactions logged involving 12 medical clinicians, which included staff talking to each other about the patient, as well as direct dialogue with the patient.

“You can imagine how complex that is for the patient, particularly if you add in that the patient’s non-English-speaking background or the elderly,” Professor Slade says.

She says handovers can be rushed and some of that may be due to the “frenetic environment” health professionals work in, as well as cultural diversity in the workplace and junior clinicians.

Dr Sally McCarthy, president of the College for Emergency Medicine, says better communication is a priority in busy, overcrowded emergency departments.

However, Dr McCarthy believes the research strongly found “pretty much none of it is attitudinal in terms of displaying any sort of disregard or lack of care or concern about patients”.

“I think the answer is focusing on better understanding by clinicians of what is necessary to achieve good communication, and this research will underpin better educational programs around that.

“The other side of it, though, is ensuring the staffing matches the capability demand, so more senior staff, less crowding, quieter and better designed emergency departments allow patients to achieve a bit more privacy and staff are not so stressed,” she says.

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