Doctor's Nonverbals

Now a small but growing body of research is revealing that the nonverbal component of the patient-doctor interaction — the subtle gestures, body positions, eye contact, touch and expressions that pass between individuals — is as critical a part of communication as verbal expressions.

To this end, medical educators have developed a host of communication courses and workshops that combine lectures, self-assessments, video recordings and “standardized patients,” or actors in the role of patients.

“We all want to be as egalitarian as possible,” Dr. Stepanikova said.

Moreover, even experts like Dr. Stepanikova, who needed to devote several hours to analyzing just portions of a single patient-doctor visit, are unsure of how researchers and educators can measure the nuances and complexities of nonverbal communication accurately, consistently and efficiently.

First, though a relative newcomer to the hospital, he had diagnostic skills equal to those of physicians many years his senior.

More recently, many schools have broadened their courses to include “cultural competency,” or the ability to communicate with those from different racial, ethnic and social backgrounds.

What puzzled me was that I didn’t normally think of this colleague as being that self-effacing.

Studies have shown that while a patient’s race and ethnicity can be linked to sharply different treatment courses and quality, better communication between doctors and patients of different backgrounds can reduce the disparities.

For nearly two decades, teaching good communication skills has been mandatory for medical schools because of research showing that good patient-doctor communication can lead to improved patient satisfaction and better health care outcomes.

Moreover, even experts like Dr. Stepanikova, who needed to devote several hours to analyzing just portions of a single patient-doctor visit, are unsure of how researchers and educators can measure the nuances and complexities of nonverbal communication accurately, consistently and efficiently.

The finding was reminiscent of earlier studies on interactions between female doctors and male patients, in which the doctors tended to give the patients conflicting nonverbal cues, combining, for example, smiles with a negative or anxious tone of voice.

Research in this area is still relatively sparse, and few medical educators are well versed in this topic.

Every so often he looked up and shared a radiant, even reassuring smile.