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The conversation with the patient: two minutes of active listening are enough in the 80% of cases

Wolf LangewitzThe work of Wolf Langewitz and colleagues Spontaneous talking time at start of consultation in outpatient clinic: cohort study offers a starting point, corroborated by empirical data, for reflecting on the moment of doctor-patient communication.

Often it is assumed that to let the patient talking could only mess-up the medical encounter. But how much time does the patient need to express him- or herself during this encounter? Just two minutes.

During the study, conducted at Basel’s University Hospital, doctors were engaged in a training with a particular focus on the active listening aspect. The results clearly pointed out that physicians don’t really risk to be swamped by patients’ narratives: in fact, for the 80% of sample’s patients, two minutes of talking by patient and of active listening by professional are enough.

These results could be supported and enriched by the work that Langewitz himself did about the better communication model to adopt during the doctor-patient encounter. According to Langewitz, good communication is a way to communicate that fulfills patient’s expectations, causes a participation feeling, protects doctor from denunciations (reducing so the recourse to defensive medicine), highlight the good clinical intervention, and has value as help to the patient.

From an EUROPEP research, conducted on an extended sample of patients indicating the main qualities a doctor must have, emerges that the “good doctor” is that one who shows him- or herself as interested in the patient’s personal situation, clearly explains what the patient wants to know about symptoms and disease condition, gives complete information, helps to manage emotions, and remembers patient’s story evolution. So, the good doctor must have not only technical skills, but also those closer to listening, to attention to the patient and to the possible emotional and everyday consequences.

How doctor could improve communication with patient? Langewitz suggests some practical advices. Communication must be simple: the patient should remember information explained by doctor, and it’s better saying less, but explicitly, neatly, and coherently.

Furthermore, is fundamental – also for a diagnostic purpose – to construct a partnership with the patient: often is the free narrative itself that allows a general idea of the situation, from which to start with more focalized questions; also, the attention to the patient’s narrative permits to understand his or her expectations regarding the therapeutic procedure.

In general, giving more relevance to the dimensions discarded because of fear that the patient will mess-up the conversation, gives a result opposed to that one expected: it reduces the non-comprehension risk, improve patient’s compliance, allows the person to feel more welcomed not only with regard to disease symptoms, but also to that emotional sphere which can’t be divided from the body that feels, suffers and face a pathology condition.

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