A Message:

From Dr. Shelley Simon

For this issue of Practice Your Way, I’ve chosen to lightly edit and reprint an article on listening that I had published earlier this year in Chiropractic Economics magazine. I’ve learned over the years, first as a clinical practitioner and now as a professional coach, that my ability to listen intently and effectively probably accounts for two-thirds of my success in terms of being able to support others in reaching their goals. I know, too, that good listening is a critical skill for healthcare practitioners to learn and use with their patients, staff, and colleagues.

Lately, I’ve also become acutely aware of the value of listening to one’s self. As the economy slowly recovers, I’m beginning to think about how to best position my business for growth in 2010 and beyond. I’m asking myself questions like “What are my clients’ most pressing concerns and what do they need from me at this juncture?”, “How can I efficiently reach the people who most need the type of coaching that I offer?”, and “What am I passionate about learning in the coming year?” Listening deeply to myself in an effort to arrive at answers to these questions has turned out to be extremely satisfying and meaningful.

As you read the article below — Three Levels of Listening — I encourage you to think not only about how the message applies to your interactions with patients, but how you can use the suggestions in the article to listen more deeply to yourself. What are your burning questions for 2010? What do you most want to accomplish next year? How can you use your gifts and talents to positively impact the lives of others? Use these questions and ones that you come up with that are unique to your life and practice as the basis for a meaningful discussion with yourself. Enjoy the dialogue and best wishes for a happy new year!

Feature Article:

Three Levels of Listening

Think about a time when someone “leaned in” to listen to you and remember how you felt heard, understood, and known. Like all of us, patients feel safe and valued when they are listened to deeply. In this article you’ll learn about three distinct levels of listening, the second and third of which are more likely to stimulate positive feelings and reactions in others.

The first level of listening is internal. Our attention is on ourselves as we try to figure out “what does this mean to me?” and “what’s in it for me?” Your patients, appropriately, listen to you at this level a good deal of the time as they try to determine if you have what they need, if you can help them, if they should trust you, and so forth. This level of listening on the part of the clinician, however, is inappropriate and ineffective, particularly in a practice where doctor and patient are purportedly working in partnership. The practitioner listening at this level is paying attention his own needs, agenda, opinions, and judgment and thinking mostly about how to get the patient to agree with him and go along with the plan he already has in mind.

The second level of listening is more focused on the patient and requires paying attention to subtle body language as well as to words. At this level, you are listening for clues about the patient’s vision for their health and what might motivate them to make lifestyle changes. The ability to read tone, feelings, and expression while demonstrating empathy and engaging in an ongoing clarification process are required here. You stay focused on the patient’s agenda while offering information, guidance, and recommendations that will help them take appropriate steps toward their health goals. At second level listening, the doctor is not rushed or thinking about what she’ll say next. Instead, she is relaxed because she knows that listening deeply (even when it takes more time) will yield useful information. This, in turn, will result in an accurate diagnosis, an appropriate plan for care, and a better clinical outcome.

The third level is called environmental or global listening. Here you are open and softly focused and listen using level two skills, plus you access your own intuition while in conversation, read nuances, and hear what’s not being said. You ask questions based on more than “the facts” because you are energetically tuned into the patient. A successful practitioner will move seamlessly between level two and level three listening and, in doing so, is better able to influence and motivate patients toward optimal health.

What are you listening for?
Because you have the intention of serving patients and making a difference in their lives, naturally you have opinions, perspectives, and your own philosophy about what is in their best interest. Yet, the key to improving health outcomes is staying focused on the patient’s needs and selectively using your skills and knowledge to coach them toward wellness as they become ready. Here are five suggestions that will help you become more skillful in listening to understand and respond to the needs and readiness of your patients.

(1) Listen for the patient’s agenda. As mentioned above, too often we listen with the focus on ourselves. We nod and take notes, all the while thinking, “What does this mean to me?” Rather than paying attention to the patient’s agenda, we’re thinking about how to drive our own. Astute patients pick up on this and factor it into their healthcare decision-making. Train yourself to stay with the patient’s agenda, meet them where they are in the moment, and provide care based on what they need and want.

(2) Listen to build trust. When you listen with interest and curiosity, you’re engaging in an authentic, shared experience. This builds trust. Active listening demonstrates that you value the patient’s perspective and respect their depth of knowledge and intuition about their own health. It’s not easy to listen well, in part because we want to control the direction of the conversation and/or the outcome. How often do you hear yourself asking “leading” questions or trying to influence a patient toward your way to thinking? Resist that temptation. Trust the patient and the patient will trust you.

(3) Listen to ask the right questions. Posing good questions is a powerful tool that must be used wisely — with an honorable intention, attitude, and regard for the patient. Ask questions that require patients to reflect on their choices related to behavior, lifestyle, and self-care and listen for clues about how you can support them with suggestions to make changes that improve their quality of life.

(4) Listen for unspoken biases or concerns. Sometimes you have to ask “risky” questions to uncover concerns that even the patient may not be aware of. For example, the gentleman who is in your office at the urging of his wife but who doesn’t really believe you can help him. Or the patient who wants to follow your treatment plan but is wondering how she’ll pay for it. Ask the question that you’re afraid to hear to the answer to, and then listen intently to the response while paying close attention to tone and body language.

(5) Listen for commitment. When you begin to sense readiness on the part of the patient or pick up on language that suggests motivation or a willingness to change, you may be hearing commitment. This is an opportunity to offer suggestions and advice, provide resources, review the benefits of positive lifestyle changes, discuss potential challenges the patient might encounter, and help them develop a plan for enhancing health and wellness.

In the coming days and weeks, pay careful attention to how you listen to patients. Keep in mind the three levels of listening and try to operate mostly at levels two and three. Always remember to meet your patients where they are, focus on their agenda, and respond to what will move them forward and help them achieve their wellness goals. When you lean in and listen — really listen — you will be rewarded with a loyal following of patients who are genuinely interested in optimal health.

An Opportunity:

Are You Ready for Coaching?

Interested in achieving a new level of practice success and enjoying going to work again? Are you ready to set aside magical thinking and playing “follow the leader” and tap into your own best ideas instead? Would you like to have more authentic relationships with your patients and staff? All of this is possible with focused one-on-one coaching. The first step in deciding whether coaching would be effective for you is to request a complimentary, introductory consultation. When you schedule this session online you’ll be asked to answer several through provoking questions as a way for you to: (a) become clear on what your most pressing issues are; (b) think about what you would like to get out of our conversation; and, (c) convey to me how I can best help you. To request your consultation, please click here.

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