In the current climate, patients’ concerns are heightened as they try to make sense of this pandemic and continue to grapple with how to stay safe and mitigate COVID-19. During these unprecedented and uncertain times, how can physicians help them navigate concerns? Through empathetic listening.
With empathetic listening, physicians can establish a strong connection with their patients to effectively alleviate difficult conversations such as wearing a mask or COVID-19 mitigation. When patients feel understood, they are often more open and responsive to their physician’s advice. Physicians may also have an improved sense of professional satisfaction.
“There’s a lot of confusion about COVID-19—whether it's how to prevent it or it’s questions about how serious it is,” said Neeraj Tayal, MD, an internist and professor of clinical medicine at Ohio State Medical Center in Columbus. “There’s a lot of treatments that are being touted in the news and people latch onto those, so they’re posing a lot of those questions to their doctors.”
“Those are some of the questions doctors are facing. As far as trying to deal with those in an empathic way, it’s pretty easy,” said Dr. Neeraj Tayal.
Husband and wife duo, Dr. Neeraj Tayal and Suzanne Tayal, MD, authors of the AMA STEPS Forward™ module, “Empathetic Listening,” share how physicians can listen and address patients’ concerns with empathy during the pandemic and beyond.
Uncover underlying issue
If a patient asks, “What do you think of hydroxychloroquine?” Dr. Neeraj Tayal recommends not answering immediately. Instead, ask the patient about the underlying question such as, “Are you worried and looking for something that’ll help you prevent infection?”
“Usually when people make statements there’s more behind it,” he said. “If the listener basically gives the patient a quick response of yes or no, agree or disagree, it usually shuts people down.”
“One of the fundamentals is to be curious and try to get at what the underlying need is or what’s the underlying fear or concern,” said Dr. Neeraj Tayal. For example, “I had a patient that had symptoms of COVID-19 and she was refusing to get evaluated, to even get tested, saying that she wasn’t sick enough to warrant that.”
“Through using some of those steps to try to get at what her underlying concerns were and really what it was, it was just fear of being hospitalized and it was a fear of knowing the results and what would then transpire afterwards,” he said. “By listening to that, then she was more open to listening to me.”
Separate education from listening
“Empathy is possible without agreeing with the person,” said Dr. Suzanne Tayal, adding that it is important to “separate out the patient education from the empathic listening.”
For example, if a patient complains about mask mandates and states that rebreathing carbon dioxide is bad for them, she explained, the “health care provider can listen without interrupting, can reflect possible feelings and needs by saying, ‘You’d like to be safe and you’d like the freedom to make choices that you feel are safe.’”
“Once the patient has been heard, the provider can give information about best practices for disease prevention, and debunk common myths,” said Dr. Suzanne Tayal.
Learn more about the six things doctors wish patients knew about masks.
Find a listening ear for yourself
“Empathy is easier when it’s also received, but it doesn’t have to be from the same person,” said Dr. Suzanne Tayal. “With all the millions of stressors in the world, providers need to find a listening ear in their family or among friends. That will make it so much easier to be empathetic at work.”
“You hear about the stressors that physicians and nurses are going through,” said Dr. Neeraj Tayal. “They need to be able to have somebody listen to them and hear them out. And if they do that, then they're probably in a little better position to hear their patient's concerns and needs and remain empathic in their communications.”
Reflect back what you heard
After hearing a patient’s concern, physicians need to reflect back what they said, which means “using their own words and saying, ‘This is what I heard you say,’ or, ‘From what you’ve told me, this is what I am understanding,’” said Dr. Neeraj Tayal. “My wife always tells me that people have a fundamental need and that is to be seen and understood.”
“We do a lot of telehealth now and we do a lot of care on the telephone. Historically we would write things down for patients and we would give it to them in writing in their after-visit summary,” he said. “But now we don’t have that ability, so we definitely try to summarize the meeting in a very crisp and clear way more than we have before.”
“You have to see the world from your patient’s perspective to see what’s going on behind that question,” said Dr. Neeraj Tayal. “If you show interest, reflect back what they said and you have good listening skills, eye contact and body language showing that you’re listening, it tends to bring them out and then they collaborate.”
“Then, not only did they elaborate, which helps you be a good physician, but it also helps build trust with you because this is a time where people’s trust is broken,” he said. “You don’t regain the trust of your patient by flooding them with a bunch of scientific data … the way you regain the trust of your patient, no matter their background, is by using empathetic listening.”