How To Actively Listen To Your Patients (As Long As They’re Men)
Medical School Role Play
Good morning medical students! In this role play, I’ll demonstrate successful strategies for active listening during medical consultations. As I move between examining rooms, note how I listen carefully and validate each patient’s concerns. And pay special attention to how I navigate through Tina’s emotional outbursts while still delivering an accurate diagnosis.
Examining Room #1 (Bob)
DOCTOR: Good morning. Sorry I’m late. What brings you in today?
[I use an apology to disarm the patient.]
BOB: I’ve been getting a lot of headaches. And I’ve lost my balance a few times.
DOCTOR: Can you tell me more?
[An open-ended question elicits more information.]
BOB: It mostly happens after I drink.
[I take notes, signaling that what he’s saying is important to me.]
DOCTOR: The headaches or the loss of balance?
[Notice I remember all of Bob’s symptoms.]
BOB: Both. The loss of balance happens when I get off the barstool. The headaches happen the next morning.
[Now I’ll head over to Tina’s room]
Examining Room #2 (Tina)
DOCTOR: Why are you here?
TINA: I’ve been getting a lot of headaches. Also, my vision is blurry, and I’ve lost my balance a few times.
[A woman with a headache! How exciting.]
DOCTOR: Menopause.
TINA: What?
[Tina isn’t listening. I need to speak more slowly and elaborate.]
DOCTOR: Men. Oh. Pause. Your reproductive life is over.
TINA: But I’m only thirty-five!
[And this matters why? See how I handle the situation.]
DOCTOR: Fine, call it early menopause. Still perfectly normal.
[Back to Bob]
Examining Room #1 (Bob)
[Bob tells me more about his situation.]
BOB: The thing is, I have a very stressful job and three young children at home, so I need to unwind after work.
[Poor guy has his hands full!]
DOCTOR: Ok, let’s take a look at you.
[I perform a few neurological tests: 1) follow my finger; 2) walk on your tiptoes; 3) walk on your heels; 4) stand still and close your eyes.]
BOB: Wow, these remind me of those field sobriety tests!
DOCTOR: HAHAHAHA!!
[Bob and I share a humorous moment which reduces his anxiety.]
[Time to hear more from Tina. Yay.]
Examining Room #2 (Tina)
TINA: Menopause would explain the headaches, but not the blurred vision or the loss of balance, right? I really think there’s something wrong.
[Oh, there’s something wrong all right.]
TINA: I think I may have a neurological problem.
[Ooh, now we’re a neurologist are we?]
TINA: Could you please just check me out?
[Maybe, if she were ten years younger.]
DOCTOR: Fine. Stand up. Close your eyes… Whoa! Good thing I was standing behind you. You could’ve have fallen and hit your head.
[At least then we’d have something to talk about.]
[Let’s go back to Bob.]
Examining Room #1 (Bob)
BOB: So, Doctor, what do you think this could be?
[I answer calmly, but honestly.]
DOCTOR: Well, you don’t have any obvious neurological signs, but your symptoms are a bit concerning. Let’s get some bloodwork done and a brain MRI just to be on the safe side.
[See how I pat his arm reassuringly.]
DOCTOR: Thanks for coming in today. It’s so important to prioritize your health.
[I brace for my return to Tina]
Examining Room #2 (Tina)
TINA: You saw my balance problem. What about my blurry vision?
[Okay, let’s just take a breath here. I’ll wave a flashlight at her eyes.]
DOCTOR: Hmm. One pupil is enlarged.
TINA: Oh no! What could that be?
[Yeah, no idea.]
DOCTOR: Do you have children?
[I’m trying to distract her; women love to talk about their kids.]
TINA: Three, under the age of six. Oh my God, am I going to die? I’m the breadwinner!
[I mean, we’re all gonna die.]
DOCTOR: It’s stress! Do you have any help at home?
TINA: No. My husband doesn’t believe in daycare.
[Trick question! I’m with the husband on this one. I mean, why bother having kids if you’re just going to hand them off to someone else? Unless the someone else is your wife; that’s different. Sorry, I got distracted, but it’s a pet peeve of mine.]
[Okay, time to shake things up.]
DOCTOR: Do you drink?
[I casually introduce this topic, so she doesn’t get defensive.]
TINA: I sometimes have a glass of wine with dinner.
[Now we’re getting somewhere.]
DOCTOR: You’re self-medicating.
[Note how I speak firmly, but without judgment.]
TINA: Um, okay. But can we please get back to my head? Can’t you order some tests?
[Enough, already!]
DOCTOR: You don’t need any tests. You’re in menopause, you’re stressed out, and you drink too much!
[Students, this is why our healthcare system is such a mess. Too many unnecessary tests! Watch how I redirect her.]
DOCTOR: Here’s a prescription for extra-strength ibuprofen. As for the rest of your “symptoms,” maybe think about the toll your little job is taking on you and your family.
[See how I’ve managed to uncover Tina’s real challenges. If I hurry, I can still make pickleball practice.]
END
