4 Jun 2008

When Doctors Listen, Patients Help Themselves

Posted by eranmagen

Compliance is a big issue in the medical world-and listening may offer a solution.

When Harry goes to see a doctor because of a bad, persistent stomach ache, the doctor may spend a lot of time diagnosing, explaining the problem, and prescribing a course of treatment – and after all that, Harry may never follow up on the treatment, and may even continue to engage in health-risking behavior.

Showing up for follow-up appointments is one form of compliance – potentially one of the simplest ways a person can invest in his or her own health. And yet, an astonishing number of people do not show up (or even schedule) a follow-up appointment that a physician recommended.

Understandably, the medical community is eager to understand how to improve patient compliance, or at least to predict when patients will comply with the prescribed course of treatment. In a study by Federman-Cook et al. (2001), researchers were curious to learn more about how patients decide not to go to their follow-up appointments. To this end, they surveyed more than 2,700 primary care patients, and asked them about a variety of factors that may influence their decisions.

One of the two most important factors was “perceptions that physicians had not listened to them.” The other was “dissatisfaction with the duration of their contact with physicians.”

In a related study by Moore et al. (2004), researchers explored these two factors more in depth, in order to see if they could pinpoint the exact aspects interactions with physicians that would predict treatment avoidance. This study did not specifically look at people whose doctors recommended follow-up appointments. Instead, they focused on people who had a medical problem which they would’ve liked to receive medical attention for, but instead chose not to. Could this behavior be explained by the nature of earlier patient-physician interactions?

After surveying more than 1,100 participants, the researchers determined that the most important factor predicting medical treatment avoidance was… (Any guesses?) The extent to which participants felt that their doctor “listened to their health concerns and took them seriously.”

It doesn’t get much clearer than that. Your ability to aid a person who came to you in search of help–even when you are the expert and are expected to know better–can still benefit tremendously from your ability to listen to the person standing in front of you, and accept this person’s experience as real and meaningful. By applying the simple, direct principles of Supportive Listening, medical service providers can help their clients feel heard and respected, and improve the likelihood of compliance with their professional recommendations. Everybody wins.

– Eran


Federman, A. D., Cook, E. F., Russell, S., Puopolo, A. L., Haas, J. S., Brennan, T. A., & Burstin, H. R. (2001). Intention to discontinue care among primary care patients: Influence of physician behavior and process of care. Journal of General Internal Medicine, 16(10), 668–674.

Moore PJ, Sickel AE, Malat J, Williams D, Jackson J, Adler NE. Psychosocial factors in medical and psychological treatment avoidance: the role of the doctor-patient relationship. J Health Psychol 2004;9: 421–33.

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