The Power of Deliberate Listening

Ronnie Polaneczky has provided an unmissable TedTalk about her quest to understand the true meaning of what she calls “deliberate listening” and the magic that happens when we set aside our judgments and just listen.

mHealth Insights

“and I said ok ma’am you said a whole lot here and I’d like to address everything you said but the first thing I want to say that I am so sorry about your son I’m just so sorry” I could feel the anger out of her was like and there was a pause and she said well thank you and I said can you tell me about your son, what was he like? she said ‘oh man, my son he was awesome he was decent and sweet and funny he would do anything for anybody who was the favorite’ now I can’t tell you everything we spoke about because we were on the phone for 45 minutes she told me her son had been at the wrong place at the wrong time and I told her that there were hundreds of murders in the city every year and it was impossible to tell all of our stories and I said I was sorry about that too because every mother’s murder child deserves a story about the time we got off the phone we have been talking mom to mom heart to heart and I asked her to please stay in touch you I could tell she was one of those great neighbourhood ladies ones who know the stories but I never heard from her again and that is absolutely ok because she had already given me something so much bigger than a story she gave me an epiphany epiphany was this when I let go that day of my anger and i was just quiet and I listen to someone despite all my judgments about them I was able to grab hold of things that” 

This isn’t very different to the type of needs that GPs are attempting to serve every day in their clinics. Do you think you could possibly do it justice with a 5 min office appointment model? How bad an idea do you think it would be to video record it and add the recording to an EHR record from where insurers and lawyers could mine the conversations for their profit?

Related: The evidence is in AskMyGP is helping GPs work at the top of their license

“the best listening happens when we suspend our right to be right…  …we have to suspend our judgments”

I think this is a big problem because society has spent 2000 years making refining medicine into a office visit based model. How big a problem is this? Well we have qualified GPs writing in popular serious newspapers that anyone who has a problem that doesn’t fit with this model of care or has vague needs is pretty much a time waster and we have incredibly talented communicators who have explained how they’ve been trained to work in a style similar to a needle dropping on a record to deliver the bit of education that is supposed to confirm to the Patient that they know what they’re talking about rather than deliver an effective piece of education.

GPs are under enormous pressure to be right and this is coming from the very top eg. today we have a situation that a Doctor will immediately fail their GP training exam if they have a mobile phone with them even though it’s hard to imagine there ever being a time when we won’t be practicing with a mobile in our pocket and the training organisations should be working towards making it a legal requirement for GPs to have a connected smartphone (loaded with up to date clinical content) with them whenever they are practicing as a Doctor. Have we all forgotten those times when they used to ban calculators from Maths exams?

A few weeks ago at the annual conference of the Irish College of GPs in Galway they had a debate on the value of video calling in which they invited Doctors who use video calls to prescribe medicines to debate for and against video consulting (we offered to contribute to the debate to give balance as we video consult but don’t prescribe prescriptions drugs like all the others but we were declined the opportunity). It astounds me that in 2016 the training body for GPs could be so out of touch with the opportunity for video to be used to just facilitate conversation between member GPs and their Patients.

Perhaps the anti-video consult Doctors had made that all to common confusion of ‘video consulting’ with ‘video prescriptions’ but I’m dumbfounded to explain why we have Doctors who can see the value for themselves using the 160 character medium of Twitter but fail to see the value and demand evidence before they’ll communicate with their Patients via Facetime calls:

I see value of 160 characters but need evidence for FaceTime calls

“so these days to keep my listening muscle and shape change the way I ride the bus to work it used to be I would get on the bus look for an empty seat preferably by the window and then I would check Twitter all the way to the office these days I’m listening ninja I get on a bus and those poor people have no idea what they’re in for I will I will look for an empty seat and I’ll sit down next to somebody and I’ll just start a conversation and I do it deliberately by my comment on something that they’re wearing or maybe the weather whatever something to get us started and if they respond I’ll ask them a few more questions and then I spend the rest of the ride focusing entirely on them with compassion without judgment in with an open heart and our conversations are just as amazing as the ones I had in Clark Park and I gotta tell you that nine times out of ten I get to work I am still filled with joy you would never know I had just been riding public transit and that’s because deliberate listening doesn’t just change the people who are listened to it changes the listeners it reminds it pulls out of ourselves and it reminds us that we’re all connected now”

This is one of the reasons I always try to use public transport and I encourage everyone I know to travel to Ireland and to use public transport when here because this is a description of what happens almost without fail on an Intercity train except it’s as though EVERYONE is trying to ‘deliberately listen’ and there are going to be prizes awarded at the end of the journey. It’s helped by the fact that most of the seats face one another (with a table in-between) but it’s incredible to experience it (the 8 people in each section will invariably tell their entire life story to one another and it normally starts with one of the passengers explaining why they’re travelling to/from Hospital or the Airport).

PS If you’re shy (and able bodied) be sure to sit at the end of the carriage next to the luggage area as you’ll be able to help others with their bags etc and that’ll immediately endear them to you.

“I have gone through a stretch where a lot of people were calling and telling me their stories in the hopes that it will go into the newspaper but I could tell after I heard them out that although their stories were personally meaningful to them they might not have enough interest for enough readers but I felt bad telling them that you know they just put their guts out to me and I had to tell them I couldn’t use their story but a funny thing happened instead of getting upset most of the time they said it had just felt so good to be listened to and they thanked me for listening to them, and I thought you know I need one day just one day where I get to sit and listen to strangers and listen to them with no responsibility to judge anything at all that they say so one day I hauled two chairs from my house into Clark Park which is a gorgeous park in west Philadelphia where they were having an arts festival and I plopped down the chairs and I put a sign on an easel said I will listen I did this with compassion without judgment and with an open heart was there something you need to say tell me I will listen to people sat down all day long they would sit down and say you know I’m just gonna stay for a few minutes and they stayed much longer and they talked and I listened to them”

I think this is such a good idea I’m going to copy and adapt it and use it next time we have an involvement in a conference as every now and then I meet delegates who are confused about what we’re offering at 3G Doctor (eg. they think we are selling technology, prescriptions, sick notes, etc) or they’re so young/healthy or medically qualified/experienced that they struggle to see the benefits we offer to those who might at certain times be so vulnerable that their needs are completely different.

I’m going to bring two very comfy/informal chairs and put up a poster. It’ll request ‘no photography/recording except with the permission of the Patient’ and while you’ll be able to ask us about 3G Doctor the idea would be to demonstrate the magic that happens when we get given a chance to ‘just’ share information and have an experienced Doctor listen to us.

Let me know if you’ve any other ways we could work this message into how we market 3G Doctor OR you have an event that you would like us to trial this concept at?

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About David Doherty
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