About the author:

Howard J. Luks, MD

Howard J. Luks, MD

A Board Certified Orthopedic Surgeon in Hawthorne, NY. Dr. Howard Luks specializes in the treatment of the shoulder, knee, elbow, and ankle. He has a very "social" patient centric approach and believes that the more you understand about your issue, the more informed your decisions will be. Ultimately your treatments and his recommendations will be based on proper communications, proper understanding, and shared decision-making principles – all geared to improve your quality of life.

14 comments on “Medicine and the Art of Listening

  • This is so true. And it’s not new – I saw the same thing 20 years ago in my neurosurgical practice. Patients sent because of an MRI or CT finding rather than a clinical need. And patients with poor outcomes because making their x-ray look better doesn’t solve their actual problem.

    When you are so full of answers after 10 years of post-graduate training at the finest educational institutions, it is incredibly hard to bite your tongue and actually listen. And it is amazing what you learn from the patient when you do!

    • Thanks for stopping by Joe! It’s obvious that I agree with you 100% !!!! High Tech-Low Touch and no Listening is a recipe for waste, unnecessary procedures, medical errors, harm and a huge waste of money…. Once again, thanks for stopping by!
      Howard Luks

  • I believe technology and social media actually increases our opportunity to listen to the patient. In the past we needed to squeeze everything into our consultation in our office, keeping in mind that there were patients waiting outside to be seen. The reimbursement I was going to receive barely covered the costs of setting up the practice, rent and staff. There was a lot of incentive to get the patient in and out as quickly as possible.
    Add to that the patient was usually nervous if not down right scared about what I was to tell them, and was paying to hear my supposed “words of wisdom” all of which was not very conducive to a conversation.

    Now with patient portals, personal health records, and social media the patient has the opportunity to develop their own rich history, which I can peruse at a time which suits me. I can ask them questions online and get an answer, which they have had some time to contemplate. If need be I can chat to them over a video conference to get more information, at a time that works for me in my practice, because the patient can do it from home rather than take the time to get to my waiting room.

    This is real participatory medicine, the only impediment being that often the current reimbursement model doesn’t pay for much of this service, so either the patient or the doctor is out of pocket.

  • Great post Howard!

    Actually we, in the sense of all of us who are in the business of innovating health care, are changing step by step by insights such as this. It proves that the interaction and interrelation between care providers and patients not only have influence of what is cognitively appreciated, but also on what is “taken” in as perception and meaning – obviously with a high impact on health outcomes of the process.

    Another influence goes through our “processing system” both consciously and unconsciously. I like to refer to the work of the Dutch professor Jozien Bensing who studied the influence of the placebo effect. See here: http://bit.ly/10DBQrw
    She is professor of Health psychology and her theme is “the power of attention”.

    So indeed, a change in attitude to listen rather than to speak may help us getting on! ;-)

    • Thank you Rob…. I see it more of a return to the relationship that people once had with their physicians. The days of high tech-low touch are upon us…. and this is leading to over-utilization of technology – over-diagnosis of routine degenerative findings – and over-treatment of entities that usually do not require evaluation or intervention. I would welcome a return to the times when we wanted to know about our patients, their stories, their issues and how that would shape their ultimate treatment recommendations — and health.

      Sometimes less is more… and sometimes … spending a few minutes listening is worth far more than any expensive tech utilization is worth.
      Howard

  • Great post. Thank you. We would probably all agree that “listening is a curative”.

    Our pressurized system of technical testing, diagnosis, treatment, prescription and volume needs an attentive human ear.

    Rhana

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