If a physician can establish a rapport with a patient and phrase questions well, it's easier to elicit the truth.
Doctors don't want to be hoodwinked by their patients, and Paul Ekman, professor emeritus of the UCSF Medical School and author of the 2001 book "Telling Lies" and inspiration for Fox's "Lie to Me" series,has spent more than 20 years teaching them how to avoid that fate. One of the things he tries to teach: Whenever people try to repress or conceal emotions, micro-expressions -- lasting only a fraction of a second -- flash across their face. It's impossible to fake micro-expressions, he says, but it's very possible to recognize them and thus tell when people are lying.
The same methods he's taught to thousands of medical professionals are now available on his website -- paulekman.com -- and anyone can learn them in an hour, he says.
The same methods he's taught to thousands of medical professionals are now available on his website -- paulekman.com -- and anyone can learn them in an hour, he says.
But even better than identifying lies once they've been told is preventing them in the first place, says Dr. Jeff Rabatin, co-director of the communication in healthcare program at the Mayo Clinic in Rochester, Minn.
To do that, "It's important to establish rapport, so the patient really feels comfortable telling the truth," Rabatin says. "Then we can be partners and work together."
Dr. Robert Klitzman, professor of clinical psychiatry at Columbia University, says doctors can encourage honesty just by asking the right questions to draw them out.
To do that, "It's important to establish rapport, so the patient really feels comfortable telling the truth," Rabatin says. "Then we can be partners and work together."
Dr. Robert Klitzman, professor of clinical psychiatry at Columbia University, says doctors can encourage honesty just by asking the right questions to draw them out.
A "don't ask, don't tell" policy, Klitzman adds, isn't productive for doctor-patient relationships. If the doctor doesn't ask about sensitive topics, it's unlikely the patient will volunteer information about them.
Just as important as the questions doctors ask is the way they phrase them. For instance, "Don't say, 'What do you mean you're not taking your meds?' " Klitzman recommends. "Instead say, 'It's great that you're taking your meds half the time. How can we increase that?' "
Doctors need to remember that sometimes patients take a long time working up the nerve to say something. "The doctor may think a conversation is over," Rabatin says, "when the patient says, 'Oh, by the way. . . . ' And it's only then that the doctor finds out the main reason the patient even came. . . . It's better to get that information up front, and it can be done with the proper skills."
The Mayo Clinic, USC and other facilities teach these skills using so-called "standardized patients" -- specially trained actors with medical knowledge. (Read more about them at www.mayo.edu/simulationcenter/documents/SimulationVideoClips.html and mededonline.usc.edu/sp.html.
Doctors who've been through the training at the Mayo Clinic simulation center say they really do feel as if there's an actual patient in front of them, Rabatin says. Their practice sessions are videotaped so they can watch themselves and also be critiqued on how they did.
But overall, with the trend toward specialization in medical training these days, communication skills may be getting short shrift, says Dr. Howard Brody, director of the Institute for the Medical Humanities at the University of Texas Medical Branch in Galveston, Texas. Then there's the problem of increasingly rushed doctors' visits. "In the future," Brody says, "you might not have a doctor you can go to who can sit down and really talk to you."
Just as important as the questions doctors ask is the way they phrase them. For instance, "Don't say, 'What do you mean you're not taking your meds?' " Klitzman recommends. "Instead say, 'It's great that you're taking your meds half the time. How can we increase that?' "
Doctors need to remember that sometimes patients take a long time working up the nerve to say something. "The doctor may think a conversation is over," Rabatin says, "when the patient says, 'Oh, by the way. . . . ' And it's only then that the doctor finds out the main reason the patient even came. . . . It's better to get that information up front, and it can be done with the proper skills."
The Mayo Clinic, USC and other facilities teach these skills using so-called "standardized patients" -- specially trained actors with medical knowledge. (Read more about them at www.mayo.edu/simulationcenter/documents/SimulationVideoClips.html and mededonline.usc.edu/sp.html.
Doctors who've been through the training at the Mayo Clinic simulation center say they really do feel as if there's an actual patient in front of them, Rabatin says. Their practice sessions are videotaped so they can watch themselves and also be critiqued on how they did.
But overall, with the trend toward specialization in medical training these days, communication skills may be getting short shrift, says Dr. Howard Brody, director of the Institute for the Medical Humanities at the University of Texas Medical Branch in Galveston, Texas. Then there's the problem of increasingly rushed doctors' visits. "In the future," Brody says, "you might not have a doctor you can go to who can sit down and really talk to you."
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