(Digested from Medical Economics, 8/18/06)
What's in a voice? A lot! Not just the spoken words, but the manner and tone in which they are spoken. As children, we are taught to say "I'm sorry" with meaning when our mothers would say, "Say it like you mean it!"
Some experts believe that the propensity for a malpractice lawsuit is based less on the physician's training, records and expertise and more on the manner in which the physician interacted with them. Analyses of malpractice lawsuits show that some highly skilled doctors get sued a lot and some doctors who make a lot of mistakes never get sued. In other words, the basis for the lawsuits goes beyond shoddy medical care.
People sue doctors when they believe they were not treated well on a personal level. People generally do not sue people that they like.
One malpractice attorney commented that one of his clients wanted to sue an internist, rather than the radiologist who was actually at fault. The reason for selecting the internist was that the patient did not feel the doctor had looked at her as a "whole person", never taking time to really talk to her about her symptoms and her treatment.
When a patient has a bad medical result, the doctor has to take the time to explain what has happened and answer the patient's questions in a complete and respectful manner treating the patient as a human being.
Recently Wendy Levinson recorded hundreds of conversations between physicians and patients. One half of the physicians had never been sued; the other half had been sued at least twice. Those who had not been sued spent an average of three minutes longer with their patients than those who had been sued. They were also more likely to make "orienting" comments, such as: "First I'll examine you and then we'll talk about the problem..." or "I will leave time to answer your questions". These doctors were also more likely to engage in active listening with statements like "Please go on and tell me more about that". They were also more likely to engage in humor and laughter with their patients. In final comparisons, there was very little difference in content or quality of information between the two groups. The difference was entirely in how they talked to their patients.
Bottom line: at first glance malpractice seems to be infinitely complicated and multidimensional. However, upon analysis, it really comes down to a matter of respect. And the simplest way to communicate that respect is through the tone of your voice. Don't assume a dominant tone, don't appear preoccupied when listening to a patient, don't talk down to a patient.
For further information, you might want to read a study by psychologist Nalini Ambady on the quality of communication between physician and patient: "Surgeons' Tone of Voice: A Clue to Malpractice History" in the July 2002 issue of "Surgery".
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