Patient Support & Advocacy

5 ways to recognize patient cues, understand needs

When physicians show true empathy while listening to their patients in the exam room, patients and their families are often more satisfied and more open to adopting their advice—and it builds a much stronger patient-physician relationship. Though it seems simple, empathetic listening requires understanding how to recognize the cues that patients offer.

Practicing empathy can save time and help physicians navigate difficult situations that arise in practice. It can also forge deeper connections with patients that lead to greater professional satisfaction and joy in work for physicians.

Listening with empathy, recognizing cues

Highly charged situations may arise in practice and those are the ideal times to use empathetic listening. The AMA’s STEPS Forward™ collection of practice improvement strategies can help you become a better listener and get to the heart of your patients’ needs.

Once you have decided that connecting with empathy is the best way to approach the patient, follow these steps to improve that skill:

  • Honor the first “golden moments.” The first few minutes of a clinical encounter are precious. There are many tasks that need to be completed during the visit—questions to ask, problems to analyze and solve—and you may feel pressured to dive right in. But if you leap into these tasks without listening first, you may miss key information. Set aside charts, computers, phones, alarms and pagers that may be distractions so that you can give your full attention to the patient and find the golden moments that reveal the patients true concerns or symptoms. Use subtle body language cues to convey that you are listening intently. You can start by sitting so that you are near to and facing the patient. Lean toward them and make eye contact. It is important to make sure that your arms are not crossed—this can signal to the patient that you are closed off and not really listening.
  • Listen for underlying feelings. Sometimes a patient’s feelings are on the surface, but other times they are hidden. A patient may bring up an emotional situation briefly and wait for the physician’s cue that it is okay to continue. Watch for feelings hidden in body language, facial expressions or other non-verbal cues and allow the patient to elaborate.
  • Listen for underlying needs or values. Deep empathetic listening means being attuned to the underlying value or need that the emotion the patient is expressing is pointing to—for example, safety or security, honesty or integrity, autonomy or control, meaning or purpose, among many others.
  • Remain present. Become comfortable with silence. Non-verbal body language such as an open and comfortable stance, eye contact, nodding your head or murmuring simple responses like “uh huh” or “oh” can show that you are listening without interjecting. Give the patient an opportunity to express feelings to completion. Their feelings and values will surface if they are given ample time to express themselves in a welcoming environment. Focus on the moments when the patient seems to display the most energy: more rapid speech, a change in facial expressions or more pronounced gestures. These signs can provide the clues to what the patient values most.
  • Look for cues that the patient has finished. These cues might be a decrease in emotional intensity, a deep sigh or a shift in the focus of the conversation. At this point, it is natural to move to another stage of the communication process—either expressing yourself, attempting to solve a problem together or attending to the needed medical care needed.

No one expects that you listen in this manner to all of your patients or coworkers all of the time. If you are new to empathetic listening, make it a goal to apply it with one person a day to learn how the process works best for you.

Increasing administrative responsibilities due to regulatory pressures and evolving payment and care delivery models reduce the amount of time physicians spend delivering direct patient care. Training yourself to recognize emotional and body-language cues can help you defuse situations where a patient is dissatisfied or struggling to express themselves in a clear way.

Check out the module for a more in-depth look at how the process of empathetic listening can improve your relationships with patients.

There are seven new modules now available from the AMA’s STEPS Forward collection, bringing the total number of practice improvement strategies to 42, thanks to a grant from and collaboration with the Transforming Clinical Practices Initiative.