Dealing With Nonverbal Communication

QUESTION: I was recently treating a patient who rolled his eyes as he agreed to proceed with my recommended chiropractic treatment plan. Normally I can tell what a patient wants to do, but I wondered if I should have addressed his nonverbal message specifically.

Posted in Risk Management on Monday, March 4, 2019

ANSWER: When a patient directly tells you that he or she will not comply with your treatment recommendation, it is relatively straightforward to deal with.  

Nonverbal communication, on the other hand, is often more subtle and difficult to address. People continually demonstrate nonverbal actions through their body language, facial expressions and gestures.

In this case, because the patient verbally agreed to the care, the patient may not have been aware that he was sending out a competing nonverbal message. In situations like this, it is advisable to:

• Acknowledge that you sense some reluctance to adhere to the treatment plan.
• Ask open-ended questions to determine what is holding the patient back, both from complying and for sharing their concerns. Is it because they don't have faith in the care? Is it an issue with the patient’s family physician? Is it the bias of a friend or family member? 
• Reassure the patient that you are willing to talk further about the issue—even if it’s something negative they heard about chiropractic or about your practice. 
• Decline to treat until there is resolution of the incongruity between verbal and nonverbal cues. It’s better to not to treat a patient rather than to have a poor outcome due to noncompliance.
• Document the behavior you observed and the patient’s response for future reference.

Essentially, determine what the patient intended to convey, encourage them to share any concerns and decide whether to proceed with treatment. This leads to a more open and honest relationship between you and the patient, helping to improve compliance with the treatment plan for the patients you decide to treat.