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Doctors Consider Nonverbal Cues in Medical Decisions

FRIDAY, Sept. 30 (HealthDay News) -- Unspoken clues -- like behavior and appearance -- influence the doctor-patient relationship, according to a new study. Researchers from the University of Michigan found subtle, nonverbal signs not only have an impact on how patients view their relationship with their doctor, they also affect doctors' medical decisions.

The findings could help doctors better understand how they make decisions and what underlying messages their behavior might send to their patients, the researchers said.

"Our findings show that both doctors and patients identified tacit clues involving the behavior or appearance of the other, but they were not always able to articulate precisely how these clues informed their judgments and assessments," said the study's lead author, Dr. Stephen G. Henry, a research fellow at the Veterans Affairs Ann Arbor Healthcare System and at the University of Michigan, in a university news release. "Not surprisingly, patients and doctors discussed these clues very differently."

After interviewing 18 doctors and 36 patients and examining video recordings of routine checkups, the study found patients took their doctor's behavior into account in evaluating their relationship, such as whether the doctor seemed hurried, was able to put them at ease, made eye contact or listened to them.

On the other hand, although awareness of nonverbal clues varies from doctor to doctor, the study revealed physicians incorporate their patients' nonverbal clues, such as body language, eye contact, physical appearance and tone of voice, into their medical decisions.

"It's mostly looking at the patient. Do they look healthy?" one doctor commented on a recording.

Doctors also consider how often they examined their patients in making judgments and in observing them for signs of depression or signals that they are withholding information or medical concerns, the study showed.

Patients' behavior may also tell doctors if certain nonspecific symptoms such as weight gain, fatigue and high blood pressure are red flags for depression or some other underlying condition, such as Cushing syndrome, the study's authors noted.

"Our findings are consistent with research from the social sciences suggesting that doctors' and patients' judgments in the examining room are often complicated and take into account many subtle, unspoken clues," said senior study author Dr. Michael Fetters, at the University of Michigan Medical School, in the release. "In the future, we hope this method of recording and reviewing these types of interactions can inform interventions designed to improve medical decision making and doctor-patient interaction by providing a more complete understanding of the kind of signals upon which doctors and patients rely."

The study was published Sept. 26 in the Journal of Evaluation in Clinical Practice.

More information

The American Medical Association provides more information on the doctor-patient relationship.

-- Mary Elizabeth Dallas

SOURCE: University of Michigan Health System, news release, Sept. 26, 2011

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