http://bmj.com/cgi/content/full/325/7364/561/a
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 Collections under
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communication Psychology
Patient
- caregiver communication (including Patient education) Patient
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A patient laughs four times during an average consultation with a doctor, according to new research.
But doctors rarely reciprocate, say the researchers, who videotaped 250 consultations in order to count the number of instances of laughter, smiles, and "smiling voices" involving the doctor or the patient or both.
The researchers, from the University of Helsinki, highlight some of the
subjects of conversation that triggered laughter in the patients
varicose
veins, pain in the leg, yeast infection, finger injury, and
cholesterol testingin a
report of the study (Journal of Sociolinguistics
2002;6:207-35).
The report, "Laughter in medical interaction," shows that in 70% of cases of a patient's laughing there was no response from the doctor. In 20% of cases the doctor did smile, but in only 10% of cases did they laugh.
"The patients laugh more than the doctors. We see that the occurrence of
laughter seldom leads to its reciprocationlaughing
together. It is the patients who do most of the laughing in medical
encounters," says the report.
It says that laughter is seen as an invitation to "come closer" and that there can be problems where it is not returned: "Not laughing with someone could indicate such negative features as mal-alignment and social distance."
The researchers cite various examples of the phenomena. One patient, aged 48, who was having his blood cholesterol level tested told the doctor that his father had died at a young age. The doctor asked him how old he had been and the patient replied: "Forty six. So I only have two more years." The doctor agreed and the patient laughed, but this elicited no response from the doctor. In another case, when a doctor was testing a patient's hearing, he whispered to the patient: "Can you hear this whisper?" The patient whispered back: "Yes" and laughed, also with no response.
Having looked at the evidence, the researchers suggest two theories for the failure of doctors to laugh along with their patients.
Firstly, the doctor's role can be characterised by attributes such as professional cautiousness and neutrality.
"Secondly, the patients mostly used laughter for different kinds of delicate
tasks. In these consultations, there are more chances for delicate
talks by the patients than the doctordescribing
one's drinking, eating habits, undressing."
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Collections under
which this article appears:Other
communication Psychology
Patient
- caregiver communication (including Patient education) Patient
- caregiver relationships Patients'
views |
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