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- July 2004 Table of Contents
- Silence is Golden
- By Dwight DeGeorge, MS, DC
How does silence work during conversation? Is it threatening? Does it cause a
sense of panic when we run out of things to say? Silence can be uncomfortable
but when used wisely in interacting with a patient, it can be a powerful
communication tool. We’ve all heard the saying, “Music is made beautiful by
pauses between the notes.” Silence is one of the more dramatic tools we can use
with patients. It can intensify the expression of excitement, shock, anger,
disappointment, and can motivate, persuade and educate just to name a few. All
these emotions can be conveyed when sound and voice are omitted with appropriate
timing.
The doctor dilemma in communicating often
becomes one of to talk or not to talk. When we talk too much or about things not
interesting to the patient, we can be boring or annoying. When we don’t talk,
the patient might get sleepy or worse, they might not realize why they are under
chiropractic care for their health! The following are several points of timeless
knowledge about the powerful use of silence for both chiropractic and
interpersonal interaction. There are many ways silence can be implemented in the
office to make greater health impact on patients and strengthen patient
retention.
Listening skills are essential for effective
doctor-patient interaction and communication. Healing begins with faith in the
doctors’ abilities to help the patient. When a new doctor works with a patient,
trust is not yet established. More times than not, patients do not like new
clinicians. Trust and faith in the doctor are very important. Trust in the
doctor begins when the patient forms a sense that the doctor understands them.
This requires listening. Hello! Are you listening? The problem is, we can think
about 5-10 times faster than we speak. Because of this, listening requires
discipline and focus.
Some of us must constantly remind ourselves to
go out of our way to give patients non-verbal cues (body language) that we are
genuinely listening to their concerns. This is important because even if we are
listening, the patient might get the feeling we are not. If a doctor has the
answer to a patient’s concern or question even before the patients are finished
expressing themselves, the doctor was likely not truly listening to everything
they were being told by the patient. Effective listening requires harnessing
one’s attention and concentrating on the patient. Doctors who fail to use
silence in listening fail to effectively communicate. “Nature has given to man
one tongue, but two ears that we may listen from others twice as much as we
speak.” — Epictetus
Silence can be used powerfully in a micro
report. Since we only have a few minutes on each visit to educate our patients,
micro-reports are an extremely effective way to communicate the chiropractic
message to the patient. Using silence within or on occasion as a complete
micro-report, can be powerful to make a strong point quickly. For example, in
the case of a patient who has been treated over several consecutive months and
has become accustomed to being verbally educated on each visit, a silent
adjustment stands out like a neon sign. The patient might spend time trying to
solve the puzzle of silence.
Questions will begin to run through their
head... What’s wrong? Is the doctor ok? Are they angry with me? At this time,
the patient begins yearning for information and is ready to hear whatever the
doctor has to say. Whatever the doctor says will now hold greater impact for the
patient. If the silence breaking statement is one about the patient’s progress
or need to take better care of something, do exercises, about their great
improvement, to stop conducting neglectful lifestyle practices... whatever it
may be, the patient is ready to listen and be captivated by it. A second silence
enhances the impact of whatever the doctor has stated on breaking the original
silence.
On breaking the first silence, the doctor might
look the patient dead in the eye and say, “I’m at a loss for words... Your spine
adjusted beautifully! It adjusted better than it ever has since I’ve been
working with you! You must be doing something right here.” Taking the same
opportunity the opposite way, “We have some work to do. What time can you be
here tomorrow?” Silence may be used to maximize impact in many ways to carry a
variety of important points to the patient.
If the doctor conveys a non-verbal and a verbal
message simultaneously, the non-verbal one is generally more influential. This
is because people trust their interpretation of non-verbal behavior in
communication more than words themselves. The doctor must be acutely aware of
both types of communication (verbal and non-verbal) at all times. If the doctor
provides contradictory body language to the way they speak, the patient will
become confused and will not know how to accurately hear the doctor.
For example, during an argument with someone
close to you, that person smiles and leaves the room. The body language of a
smile contradicts the argument and causes confusion. If the same person were to
scowl and leave the room during an argument, the body language is consistent
with aggression, which is an emotion generally intermingled with verbal
argument. The resultant emotion of changing one facial expression in the same
action can be completely different! Body language is especially powerful in
silence.
During an adjustment, when a generally
talkative doctor becomes silent, the patient might look up to gauge the body
language of the situation (considering it is a stronger communication device).
If the doctor were to smile, the patient would be reassured that everything was
O.K. but would remain in their confusion about the silence and be ready to hear
what the doctor had to say. If the doctor were to shake their head when the
patient looked up, the patient would feel something was wrong but would still be
anxious to hear what the doctor had to say. From this point, there are many
powerful communication tools at the doctor’s disposal but explaining them in
this short space could not do them justice.
Silence is powerful in the arsenal of the
doctors’ communication toolbox. When used correctly, it greatly impacts patient
learning, motivation, and emotion, ultimately causing referral, retention, and
practice growth!
Use silence. Be effective.
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