Communication Skills - Non-verbal Communication

The following has been adapted from an Academy News report by Carolyn Rogers, published February 16, 2002, on Joan Damsey's (founder of Damsey & Associates, Ltd., a practice management firm in Norfolk, VA) approach on non-verbal communications.

"Between 55 and 70 percent of your communication is non-verbal," says Joan Damsey. "Only about 7 percent is actual words used and the rest is tone of voice, etc."

The following acronym is a easy way of remembering and adapting non-verbal communication skills in your day to day patient encounters...




S - is for smile. A smile helps set patients at ease and generates positive feelings about you and your practice. This in turn breaks down barriers so you can uncover issues more quickly and openly.


O - is for open posture. Open posture-which means no crossed legs, arms or hands-says you are approachable and willing to interact. Arms drawn across your chest, on the other hand, can be intimidating or even condescending to patients. It suggests "I'm closed to what you have to say," which often makes patients feel they must explain themselves extensively just to get past your barrier. Or they might put up their own defensive barrier in return. Either way, it's an obstacle that takes extra visit time.


F - is for forward lean. Lean forward, but ever so slightly, so that you're not in the other person's body space. Whether you're standing or sitting, this forward lean tells the patient "I'm trying to get closer because I really want to hear what you have to say."


T - is for touch. It's extremely important to touch patients. As you walk into the room, shake hands with the patient in a warm and friendly manner. Or, if the patient is over 70 or so, perhaps a tap on the shoulder might be more appropriate. But by shaking hands with the patient, the doctor not only sends a friendly nonverbal message, he or she can also learn lot about the patient's psychological state. Is the hand warm, cold, jittery, sweaty? All are clues that may save you time.


E - is for eye contact. Eye contact is probably the most important nonverbal communicator after smiling. Eye contact conveys that you are paying attention to the individual, not being distracted by your notes or something else on your mind. However, if eye contact is maintained 100 percent of the time, it's bound to be uncomfortable for both the communicator and the receiver. So, try to maintain eye contact about 80 percent of the time. Use caution, though, and do not gaze directly into the patient's pupils, but rather within a 3- to 4-inch orbit of the eyes. The point is to help the patient feel you are connecting with them, not staring them down.


N - is for nod. As your patient speaks, it is important to nod occasionally. You're not necessarily nodding in agreement, but rather as a nonverbal way of saying "I hear you?I understand what you're saying." Nodding also encourages the patient to move along with their story. Very often physicians have heard the same story five times already that day, and they cut patients off-something many patients find offensive. But if you nod, the patient will speed up and get their message across more quickly because they know that you understand them.


Some non-verbal cues to avoid include:

  • Tapping fingers, pens, pencils
  • Clenching fists
  • Yawning
  • Looking out the window
  • Tapping your feet
  • Crossing arms or legs
  • Shifting weight from one foot to another