Jazz offers lessons for doctor-patient interaction

Toronto -- In many ways, a physician is like a jazz musician, says internist and jazz disc jockey Paul Haidet, MD, MPH.

Doctors have to improvise during office visits. They determine when each person should play his or her part. And they have to hold the rhythm of the visit together, or the session may fall into disharmony.

Physicians can learn a lot about communication by listening to jazz and watching its musicians perform, Dr. Haidet said.

"Jazz is all about harmony in communication. When jazz musicians play, they play in a way that goes along with [how] the rest of the band is playing," said Dr. Haidet, director of medical education research at Penn State College of Medicine. He also is president-elect of the American Academy on Communication in Healthcare.

Dr. Haidet and Gary Onady, MD, PhD, an internist and pediatrician, led a session at the American College of Physicians annual meeting aimed at educating physicians to use the characteristics of jazz to improve their patient communication skills.

They described a physician's range of skills within his specialty as his instrument. They compared a patient's chart with song sheets. The riff, they said, is a physician's rapid recall of knowledge.

A physician needs to be ready to improvise when he or she walks into an exam room and encounters unexpected aspects of a patient's illness, Dr. Haidet said.

But once in the room, physicians should not think of themselves as the only person in charge, Dr. Onady said. Rather, he recommends doctors "assign solos," allowing the patient and others in the room to discuss their concerns one at a time.

Doing so makes the patient realize the physician is listening. It also enables the doctor to hear more about symptoms and possible causes and gets a more complete picture of the medical problem or concerns, said Dr. Onady, professor of pediatrics and internal medicine at Wright State University Boonshoft School of Medicine in Dayton, Ohio.

He also urges physicians to pay attention to patients' body language. For example, if the patient is staring blankly while the physician summarizes medication instructions, it's time to try a different approach, said Dr. Onady, a jazz musician in the Eddie Brookshire Quintet.

"The doctor needs to think, 'I'm not harmonizing with the patient. What is it going to take? Am I too technical? Is it my inflection?' "

He acknowledges that physicians' limited time makes thorough discussions with patients a challenge. But he points to jazz musicians who, when improvising, have to determine very quickly where they are going to take the music.

Communicating efficiently in a small amount of time is a learned skill, Dr. Onady said.

Internist John Cary, MD, attended the session at the April meeting in Toronto hoping to pick up tips to improve his communication style during office visits. He said the concept of "assigning solos" by giving the patient time and space to speak -- rather than doing all the talking himself -- is an important lesson.

"I'm increasing my awareness of rhythm and timing and everything else that goes into communication besides the words coming out of your mouth," said Dr. Cary, who works at a three-physician practice in Manassas, Va.