Interactions between a doctor and a patient include verbal and nonverbal communication. Verbal communication speaks for itself.

Nonverbal communication, however, can further be broken down into vocal cues such as voice, volume, pitch and speed of speech, and body language, which includes facial expressions, posture, gestures, eye movement, touch, and positioning.

“Often, our nonverbal cues have a greater impact on the interaction,” said Jon Mullin, MD, an associate professor of pediatrics who also oversees communication skills education at WashU Medicine in St. Louis.

Most of us can recall instances where something communicated conveyed a different message than the words said. This is an example of how nonverbal communication can be important. “In most cases, it is the nonverbal cues that carry the most weight in how we interpret what was meant,” Mullin continued.

These Dynamics of Nonverbal Communication

Body language says more than words. Here are tips Mullin suggests being to ensure your patient is comfortable and your nonverbal cues and actions match your intention and verbal messaging.

Listen attentively. Be sure to convey that you’re listening to the patient, that you value their time, that you value your relationship, and that you aim to be compassionate, respectful, and adaptive to their circumstances.

“Attending to the nonverbal aspect of your communication is essential to have this desired impact on the patient,” Mullin said.

Watch body language. Standing over a patient, having crossed arms, leaning back, avoiding eye contact, and the lack of any nods or gestures in response to the patient can all be interpreted as a lack of interest, dismissive, or at worst, lack of caring, said Mullin.

Be authentic. It’s up to each of us to find what body language we feel is comfortable and authentic, to monitor our impact on our patients, and to adapt to each patient as needed. “This is easier said than done, as we have a lifetime of communication experience that we bring to medicine and to each encounter,” he said.

Consider feedback. Become conscious of your nonverbal communication and identify how your body language affects your interactions. Mullin said options include reviewing video recordings of encounters (which may be available to learners who practice simulation with standardized patients) or direct observation and feedback from a colleague or supervising physician, especially one who is primed to observe and comment on body language.

Be open to change. Because of the subconscious and ingrained nature of body language, change can be difficult. “Based on the observation and feedback, start by identifying one aspect of body language to perform differently. Focus on that one component change and monitor the impact,” suggested Mullin. “At first, the change will feel unnatural, and once you notice a positive impact on your patients, it can quickly start to feel natural.”

Do Patients Take Body Language Cues From Physicians?

The body language of physicians and patients influence each other as people subconsciously mirror each other’s body language in interactions, he said. “If we take a minute to pause, sit down with open posture, lean in with eye contact as we start the interaction, we may find our body language subconsciously influencing the patient to take on some of the same behaviors,” continued Mullin. “This attention to body language can help to enable partnership in the encounter in addition to the concomitant verbal communication.”

Why Patients Are More Receptive to Positive Body Language

“Patients come to doctors with the hope that we will be able to prevent or treat illness, offer needed information, alleviate suffering, and walk with them no matter what they face,” said Naomi Rosenberg, MD, associate professor of clinical emergency medicine and assistant dean for narrative medicine and health humanities at the Lewis Katz School of Medicine at Temple University in Philadelphia. “Given that enormous privilege, why wouldn’t we work hard to make our moments with them as comfortable, trusting, and compassionate as possible?”

Research demonstrates the impact of physicians sitting during encounters. It has been shown that sitting increases patient perception of time spent and increases patient satisfaction.

“Patients will always interpret our body language, and with careful attention,” said Mullin. “It can be a tool wielded to show our patients that we are compassionate, respectful, value them as people, and value the doctor-patient relationship.”

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