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"I don't need your pills, I need your attention:" Steps toward deep listening in medical encounters
Ronald M Epstein1, Mary Catherine Beach2
1Center for Communication and Disparities Research, Departments of Family Medicine and Medicine (Palliative Care), Wilmot Cancer Center, University of Rochester School of Medicine and Dentistry, 1381 South Avenue, Rochester, NY 14620, USA.
Abstract:
Patients highly value being listened to, taken seriously, heard, and understood; indeed, listening to patients is essential to alleviate suffering. Yet listening as a clinical skill has been virtually ignored in the training of physicians. In this paper, we synthesize literature related to listening in medicine and explore the internal and external challenges and complexity of listening - including the need to listen with a diagnostic as well as a relational ear to take in physical symptoms, emotions, and contexts - often in chaotic and time-pressured environments. We suggest physicians focus on the development of "deep listening" skills, involving cultivating curiosity, openness, reflective self-questioning, and epistemic reciprocity; we also suggest how to ensure patients know they are being listened to.
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