By Morgan Wilson Take the popular television shows, House M.D. and Grey's Anatomy, for instance. These medical drama series are centered around the professional and personal lives of physicians that work in hospital healthcare settings.
a knack for catching subtle hints and accurately determining difficult-to-catch diagnoses.
Now, let's examine their nonverbal communication skills by watching two short video clips.
Do you think the patients of either of these fictional physicians would be satisfied?
In healthcare settings, nonverbal communication primarily involves the communication of emotional cues through facial expressions, body postures and movements, and the tone and inflections of voice. Physicians' ability to communicate, or encode, these emotional messages in nonverbal channels as well as their ability to understand, or decode, their patients' nonverbal cues are both equally important for achieving patient satisfaction. Failure to communicate emotions effectively results in encoding errors, where negative emotion was communicated while intending to communicate positive emotion. As I'm sure you can imagine, such errors significantly lower patient satisfaction levels. Encoding also helps physicians establish rapport with patients in situations where verbal expressions of caring and concern may be uncomfortable or inefficient. Furthermore, if physicians do not decode effectively, they may fail to identify patient dissatisfaction or distress if the patient is reluctant to express their feelings verbally to their physician.
At the time when the article "Predicting Patient Satisfaction from Physicians' Nonverbal Communication Skills" was published in 1980, the impact of verbal communication on patient satisfaction had been observed and examined far more than the small amount of research that had been conducted on the role of physicians' nonverbal encoding and decoding skills in patient care. Although, authors DiMatteo, Taranta, Friedman, and Prince were not the first ones to take note of the significance of nonverbal communication in healthcare. The importance of physicians' nonverbal communication skills has been recognized by physicians as early as Hippocrates and Osler. To examine the relationship between physicians' nonverbal communication skills and their patients' satisfaction with their medical care, two studies were conducted. This research was completed at a 478-bed community teaching hospital in New York City during the mid-1970s and involved a total of 71 residents in internal medicine and 462 of their ambulatory and hospitalized patients. According to DiMatteo, Taranta, Friedman, and Prince, these studies showed that physicians who were more sensitive to body movement and posture cues to emotion received higher ratings from their patients on the art of care than less sensitive physicians. Additionally, physicians who were successful at expressing emotion through their nonverbal communications tended to receive higher ratings from patients on the art of care than physicians who were less effective communicators. Therefore, they found that measures of these skills predict patient satisfaction with the art of medical care received. The article explained that patients' overall satisfaction with medical care tends to be best predicted by their satisfaction with the dimension of physician conduct, which comprises two aspects:
Patient satisfaction is an important component of the quality of medical care as it can influence patients to adhere to medical regimens, while dissatisfaction can result in malpractice litigation and doctor-shopping. Each of these subsequent patient behaviors influence the cost and effectiveness of healthcare. DiMatteo, Taranta, Friedman, and Prince stated that, when patients are dissatisfied with the affective side of the medical care they receive, "many patients change physicians ('doctor shop') because they are dissatisfied with the impersonal treatment they receive and with their physicians' seeming lack of interest in them." They believe that change like this can be wasteful because it results in "needless duplication of examinations and procedures." But healthcare records have changed quite a bit since this article was published in 1980. Now, many patient files are stored electronically and can be shared with the patient as well as other physicians and healthcare practitioners with the proper permission. Despite this modern increase in the ease of access to records, however, I know from personal experience that some physicians may prefer to reperform some examinations and procedures again themselves, thus resulting in the "duplication" that DiMatteo, Taranta, Friedman, and Prince discussed in their article. These two studies showed that the patients "expressed greater satisfaction with physicians who were sensitive enough to decode body posture and movement cues to emotion." Such physicians are possibly more adept at recognizing dissatisfactions and discomforts that patients are unwilling or unable to express verbally and, therefore, more adept at satisfying their patients' socioemotional needs. Both studies confirmed that physicians' skills for accurately perceiving body movement cues to emotion was a significant predictor of patient satisfaction with the art of care. Through analyzing the data collected during the studies, DiMatteo, Taranta, Friedman, and Prince were able to conclude that physicians who were more sensitive to body movement cues to emotion and better able to communicate emotion nonverbally tended to be somewhat more successful at satisfying patients' socioemotional needs than physicians that lacked sensitivity and emotional expressiveness. Source:
DiMatteo, M. Robin, et al. “Predicting Patient Satisfaction from Physicians' Nonverbal Communication Skills.” Medical Care, vol. 18, no. 4, 1980, pp. 376–387., www.jstor.org/stable/3764191.
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Hannah Cox Archives
April 2017
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