Reducing Risk By Improving Listening 

by Rebecca Shafir

“Five minutes spent listening to the patient can save five hours of deposition time.” 
- Anonymous lawyer 

Most patients would agree that a doctor who listens mindfully is one who:

• Takes in the whole message – not just the words themselves but the tone of voice, the body language and the pauses between words and phrases.

• Sustains full attention to the speaker over time.

• Makes the speaker feel valued and respected for their point of view.

• Listens to oneself (chooses their words carefully, is sensitive to the listening style of others, offers complete information in understandable terms).

Examples of poor listening that can result in malpractice claims when :

• Patients may perceive a lack of caring and empathy by the physician’s lack of eye contact or attentive silence, frequent interruptions, one hand on the doorknob, finishing their sentences for them, looking at their watch, not responding to feelings associated with their symptoms, not returning their phone calls e-mails, etc. 

• Doctors use technical medical jargon without explanation and supply no simple written instructions of procedures and medications.

• There was inadequate informed consent (either a discussion never took place or the patient was inadequately informed of recommended procedure risks and benefits, provider identity, or alternative treatments including their risks and benefits).

How much communication is enough?

Without answers to these eight basic questions, and any others the patient might ask, dissatisfaction can lead to needless lawsuits:

• How accurate is the diagnosis?

• What are the odds of a cure?

• How necessary is this procedure?

• What can go wrong?

• Should I get another opinion?

• What will happen if I don’t agree to the treatment?

• Exactly what are you going to do?

• How long will it take me to get back on my feet?

Research: Some points to ponder

94% of patients seek good communication skills from their physicians (AM News December 1996 public opinion poll) 

JAMA 12/22/99 published a study from the Univ. of Washington concluded that 9 out of 10 decisions made between doctors and patients failed to include enough info to allow patients to make informed treatment decisions.

British cancer Research Campaign, European Journal of Cancer 12/22/99 reported that patients typically remember just over 50% of the info they receive from the doctor about their diagnosis and treatment. But this figure drops to 25% for cancer patients as anxiety levels are higher, which reduces their ability to remember details. 

JAMA 1999 study found that average time to interruption by the physician was 23 seconds. (See an interesting article in 1999 Journal of Clinical Oncology titled, “Can Forty Seconds of Compassion Reduce Patient Anxiety?”) 

71% of patients in a 1994 study stated that poor relationships as the cause of their malpractice claims.

1997 study by Dr. Wendy Levinson of University of Chicago indicated that primary care physicians who had never had a malpractice suit brought against them spent 18.3 minutes vs. 15 minutes per patient visit.