AFPI Karnataka Newsletter

Issue: Volume 5, Issue 1

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Family Medicine: Transforming the Dying Art of Listening in Clinical Practice

Dr Prathamesh S Sawant (Co-Founder & Executive Director: AVEKSHA Home Based Primary Care, PCMH Restore Pvt Ltd)


Being in our busy and buzzing clinical practice, many of us these days have lost the art of listening in everyday clinical decision making. I was reading up this morning on what is different in us (as Family Practitioners) listening to patients and some other doctors doing the same in their own settings. And came up across Deeya Khan and her documentary - White Right: Meeting The Enemy that talks about a story of a Muslim woman living in the UK, trolled by white supremacist to the point where police got involved because her life was at risk. They even asked her to stay away from open windows, that’s how bad it got.

The way she responded was to travel to the United States to meet the white supremacist with her camera gear and gives them a safe space to feel heard (basically they all wanted her off the planet, but she wanted to hear them out). As the conversation goes ahead they feel heard and start trusting her and become friendly with her. The story continues where they are able to open their eyes or find solutions even in the extreme conditions and change themselves just by being heard.

So listening is not just the act of hearing what’s spoken, but it’s the act of understanding themeaning behind the words. With the story above I feel listening can be of two types.

  1. When people say you are not listening, most of the times people repeat their words what they have heard (congratulations it’s our ears that are working) this is “The Act of Listening”

  2. “The Art of Listening” is to create an environment (safe space) in which the other person “feels heard”. People or if we ourselves are in their place we don’t want to know they or we have been heard, but they truly want to feel heard/seen/felt and it’s a learnable and practicable skill.

It can be as simple as creating a safe space to empty the bucket (as this documentary demonstrates - once the person feels like they have completely said everything, then they are more apt to listen to you, but usually we tend to defend or litigate or interrupt or find flaws in logics as we know we are imperfect and we choose the speak the wrong words various times and the conversation spirals down on what we meant and what someone interpreted) or as simple as replacing judgement with curiosity. Another inspiring talk was by Disha Oberoi (RJ; Hear her most mornings on the radio while driving through the traffic in Bangalore) on TEDx where she demonstrates different sounds and navigates people to appreciate the beauty of it. The part on “Indian Blind Cricket Team” was fascinating.

There are these 2 forms of listening I came across in my reading, and learning more on how can I or anyone embrace it into their daily living.

It’s now been ~3 years of me practicing as a part of Family Medicine team. In addition, to being privileged to experience several Family Practice settings across the country. I believe the art of listening is one of the major component that drives us (as Family Practitioners) and keeps us going as an entire team. No matter the doctor seeing one patient an hour or 15 patients an hour or 150 patients a day, just listening to them and seeing a smile on the patient or families is beyond words. Incorporating this art in our everyday practice can minimise several unnecessary interventions (Investigations, Drugs, Procedures etc) and enhance their quality of daily living.

This is one of the major component to our patients/family relationships and trust (going generations) in family practice. I believe there are several of us practicing with this art of listening almost every day to touch and transforming life of many communities.

References

Deeyah Khan: Solidarity doesn’t cost anything (TEDx); Available at: https://youtube.com/watch?v=3zhYY4KQRX8

Disha Oberoi: Dying Art of Listening (TEDx); Available at: https://youtube.com/watch?v=mkGvy2QcG6Y