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Can Acting Lessons Help in the Patient Encounter?

Greg Hood, MD, Internal Medicine, 04:02PM Mar 23, 2014

All the world's a stage, And all the men and women merely players. - Wm. Shakespeare

There is nothing more real, more sincere than a physician's encounter with each patient. Consequently, it may seem incongruous to look to the profession of acting for lessons on interacting with patients. However, at its essence, a patient encounter, like a scene between actors, involves interpersonal interactions, context, storytelling, and dialogues. The earliest descriptions of acting described in terms of "rhetoric", which is defined as, "the art of discourse, an art that aims to improve the capability of writers or speakers that attempt to inform, persuade, or motivate particular audiences in specific situations."

Is there a more fitting description of a physician visit? Furthermore, like a TV show, movie or play, office visits have a structure to how the story is unfolded. Each visit has its unique plot, and is conducted in "acts". There is the history taking, with its back and forth dialogue (hopefully not a monologue) , followed by, or blended with, the examination, and then the denouement as the diagnosis and treatment plan is revealed. If this structure isn't followed overall, if, for example, the examination is omitted, or the conclusions and treatment plan come at the beginning, then the consumer, the patient (and perhaps the family in attendance) leave disappointed or confused.

There is also "looking the part". One of my classmates in medical school was given a challenging psychiatric patient to see at the VA. New to the rotation, he wore his white coat. He did so, because he had just come off a medicine rotation and did not know that the psychiatrists and teams at the VA did not. When he entered the patient room (stage left) the vet's face brightened. The patient said, "Oh, you're a REAL doctor?". He then proceeded to open up, for the first time, and progress was made in his case. It is for such reasons that there are such lengths as taken to select casting and wardrobe in professional productions.

Some skill sets for actors, such as clarity of speech, emotional facility, body language, improvisation, observation and interpretation all translate very well to critical skills for physicians. However, it was another most critical skill that an internist-actor friend of mine highlighted as the area in which acting has helped him the most as a physician. His feeling is that his acting classes taught him how to listen better, to actively and deeply listen. In turn he feels that this has helped him react and respond with greater depth within the exchange with the patient. This improvement in listening skills has additionally translated into better observation skills.

Some physicians find interpersonal skills to be an intuitive skill set. For the rest acting lessons can be an avenue to more effectively demonstrating the feelings and emotions appropriate to the moment and the encounter. This doesn't mean "faking" emotions, in the least. To the contrary, the better one is dialed into one's own emotions, motivations, and the dynamics of the visit the more appropriately one can demonstrate the compassion and warmth, as well as knowledge that is generally expected.

In today's healthcare environment, in which there is so much pressure on time, distractibility of the EHR, and other interruptions it has only become more challenging to nurture and build upon patient trust. Lessons in body language, eye contact, vocal inflections, facial expressions, movements and even breathing patterns all can improve the tenor, and hence the outcome, of the visit. Such training can improve the perception of empathy, a critical connection between physician and patient. Not just a touchy-feely difference, these practices can also improve the quantity and quality of information gleaned from the encounter.

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Poll: Acting lessons: I've tried, and they helped me in patient encounters.|I've tried, but they didn't help me in patient encounters.|I'm considering, to help me in patient encounters.|I'm considering, to help me in my next career.|Are not for me.|
About This Blog

One internist's personal views on the practice and business of medicine, posted each weekend.

2012 Winner of Web Health Awards, receiving both Bronze and Merit certificates.

Disclosure: Gregory A. Hood, MD, has disclosed the following relevant financial relationships:
Served as director, officer, partner, employee, advisor, consultant, or trustee for: Kentucky Chapter of the American College of Physicians, American College of Physicians
Served as a speaker or a member of a speakers bureau for: GlaxoSmithKline

Poll: The Internet Provides a chuckle when I need it|Helps me find answers|Wastes my time|Frustrates me|All of the above|

  • Greg Hood

    Dr. Greg Hood is a practicing traditional internist in Lexington, Kentucky. He is also the medical director of his local Independent Physician Association (IPA) and is active with committees covering many different professional services. He has published and spoken on a wide variety of clinical and nonclinical subjects, including issues of work-life balance, workforce planning, and healthcare funding and reform. He was the recipient of leadership awards in 1996 and 2004. Dr. Hood is a past-president of the California Society of Internal Medicine and is a past-governor of the Kentucky chapter of the American College of Physicians.

The content of this blog does not necessarily reflect the viewpoints of Medscape.
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