Blog | Thursday, February 21, 2019

Doctor, commit to eye contact

Eye contact is one of the most basic mammalian traits that signals an interaction. Anybody who has a dog or cat at home, sees on a daily basis how much animals value eye contact (and with dogs, it signals you've lost the battle!). In the case of healthcare, during frequent emotional exchanges between two human beings, it naturally follows then that simple eye contact has to be at the core of the doctor-patient interaction. I write and teach a lot about communication skills that physicians should foster. But sadly eye contact is something which appears to be falling by the wayside these days—as it is in society in general. Technology may be bringing immense benefits to mankind, but there are also drawbacks, and reduced eye contact with our fellow beings is one of them. Nevertheless, humans will always be humans, and crave one-on-one contact and attention.

A few weeks ago over the Christmas Holidays, I was back in England visiting my parents. We were getting some work done in our house, having a new electrical system installed that can be controlled via a smart device app. I was being shown the app by the installer, and as I struggled around with it a bit, my mom joked that I was used to spending a lot of time with technology as a doctor (she reads my blog too). The installer then quipped: “My doctor doesn't even look me in the eye any more during my appointments, and spends his whole time on the computer!” I have heard statements like this countless times (often patients complaining to me about other doctors), and do feel very sad and disappointed when I hear this. I wrote about this not so long ago in this article. What's more disappointing is that this was in England, where previous feedback I've received is that electronic medical records are much better than the U.S. (more user-friendly), and there are no requirements for bloated notes or billing issues.

So what's going on with our profession? I don't think any physician ever deliberately sets out to give their patient a suboptimal experience or the appearance of giving them inadequate attention. We are all trying our best within the confines of the system and limitations placed upon us. But when it comes to eye-contact, is there any way to ensure that no patient comes away with this unacceptable viewpoint that their doctor didn't even look at them? Can we resolve to always at least try to look directly into the eyes of our patients for a set amount of time before we get onto a computer or start examining them? Or pause during the interaction to do this? Even just 1 or 2 minutes uninterrupted listening time may be enough, and is something I always hold myself to, even when I'm in an extreme hurry.

Like any profession, there are some doctors who are naturally better than others at communicating. But the amount of eye contact we give is something we should always have an acute awareness of during our workday (this article here even called it the “therapeutic gaze“). Even when we are speaking to other colleagues including nurses, I frequently see physicians with their head buried in the computer, not even looking up when they are being given information or asked a question. It's an easy enough thing to forget to do in the haze of a crazy day, but is always duly perceived by the person we are interacting with.

The famous author and wellness expert Richard Moss once said, “The greatest gift you can give another is the purity of your attention.” This includes eye contact. So wherever you are over the next few days, I challenge you to commit to looking up and making more eye contact when someone is talking to you for at least 10 seconds (or ideally longer) instead of having your head buried in your device or whatever else you are doing. You of course have work to do and things you are looking up on your device, but try this for just a few seconds more than you otherwise would. Communicate the good old-fashioned way that all mammals are designed to do. At home or at work.

Suneel Dhand is an internal medicine physician, author and speaker. He is the founder of DocSpeak Communications and co-founder at DocsDox. He blogs at his self-titled site, where this post first appeared.