Hearing and Listening

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13 Sep 2016 - General

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Hearing by definition is merely one's awareness of a sound while listening requires paying attention to the sound that one hears. When we hear, we can opt to tune out the sound. Listening is different because we try to understand the sound that we hear. Why am I mentioning this? I have noticed that most healthcare professionals hear but do not listen, especially in the early stage of their careers. We tend to cut the patient's story when we feel that he/she mentioned a pearl that needs a follow-up question. History taking then becomes an inquiry of what we want to hear based on the bias of our diagnosis than a communication wherein the patient can give more important details. Communication is key in healthcare. One of the most important skills that we need to develop is to become a good listener. Once we are able to listen and give uninterrupted attention to the patient, rapport is established and a comprehensive patient history is being offered without questioning. As Bates' guide to Physical Examination has emphasized, this important sentence holds true "Listen to the patient because he is already giving you the diagnosis."

For the MIMS community, do you follow this approach of asking open-ended questions or do you prefer a directed and focused history taking approach?

Mark Edmon Tan I think the history taking approach depends on the situation. For emergency cases, I usually perform a directed and focused history taking approach. Even the physical exam is targeted to rule out other emergent neurologic conditions. After urgent health concerns are addressed then you can perform a more thorough history taking and physical examination. This actually helps in establishing a profess...
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Maria Cristina Inserto "Patients are used to just opening their mouths right away." That is just unfair to inspect without even probing of the possible cause of pain. I agree that most if not all of healthcare professionals went through this mistake in the early years of their career. We thought that rushing to retrieve information would make history taking easier but it will not. The patient will almost...
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In my clinic, when a patient sits down they often start with the declaration of what they need and feel, the chief complaint, which is usually "My tooth hurts." I don't remember when I started doing this, but for awhile now, after I hear that I'd always say "Okay, so tell me the story of that tooth." They often do not understand, but basically I want them to tell me what that tooth has gone through before I even look at it. And then I look at it. Then based on what I ...
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Priscilla Mae Gobuyan Great to hear that you are using open-ended questions. It will be very difficult to understand how a patient is truly feeling if we do not give undivided attention. Listening is really more challenging and I have to admit that I am guilty of cutting off a patient's story sometimes. However, I always regret doing so because patients seem to hold back on details when interrupted. Allowing ...
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Way back in college we are taught about therapeutic and non therapeutic communication. Having open ended questions are classified to be therapeutic compared to those which are close ended questions. I have to agree that not just me but almost all people, there will be times that we tend to just hear people when they talk and not listen to their sentiments. Listening to the patient is really one of the steps to get their empathy and help them trust you as a healthcare provider. Listening would al...
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