When you visit a doctor, you expect them to listen. But in today's fast-paced health care system, real listening -- the kind that makes you feel seen, heard and understood -- can be the first thing to go.

A new article, co-authored by Dr. Leonard Berry of Texas A&M University's Mays Business School, argues that listening isn't just a nice gesture, it's a powerful tool that can improve your care and even help heal the health care system itself.

Berry and colleagues at the Institute for Healthcare Improvement in Boston and Henry Ford Health Detroit published their findings in Mayo Clinic Proceedings.

The Case Of The Norwegian Nurse

The team identified what it calls "values-driven listening." It's about more than asking questions, it's about asking the right questions, being present and showing genuine curiosity and compassion.

"Listening is the gateway to healing," Berry said. "It's how we connect, understand and ultimately serve better."

One story in the article shows just how transformative listening can be. A nurse in a Norwegian nursing home asked a patient, "What would make a good day for you?"

The patient responded: "I want to wear my blue shirt."

"Why the blue one?" the nurse asked.

"That was my wife's favorite shirt," the patient said. "She died two years ago today, and I want to honor her."

The patient shared memories of his wife with the nurse, and afterward, he asked for a wheelchair so that he could tell other patients about her; it was the first time he'd ever asked to interact with other people at the facility.

"That's not a medical breakthrough," Berry said, "it's a human one."

Six Listening Strategies

The authors outline six types of listening that contribute to better care:

Listening That Is Proximate Being physically present matters. Your provider can learn far more from a quiet moment in the exam room than from a rushed message or chart note. When they're close, focused and curious, you're more likely to open up, and that kind of trust is essential for making decisions together about your care. Be sure your provider spends this focused time with you.

Listening That Is Curious Your provider's curiosity can be just as important as their expertise. When they ask open-ended questions and pay attention to your words, body language and emotions, it creates space for honest conversation. That's often when key details emerge informing the plan of care. "What are your concerns about the plan of care we've discussed?" creates a path for open dialogue in a way that "Do you have any questions?" does not.

Listening That Earns And Enables Trust Trust starts when you feel safe to speak candidly, and that happens when your provider listens without judgment, gives you their full attention and treats your input as essential. At Henry Ford Health, some doctors are using AI-powered tools to handle notetaking during appointments, so they can focus entirely on the conversation.

Listening Aided By Design The design of a clinic or hospital can affect how well you're heard. Small, crowded spaces make private conversations harder, but simple changes -- like your provider sitting down during a visit -- can make you feel more cared for and listened to. Some health systems, like Southcentral Foundation in Alaska, have created "talking rooms" that feel less clinical and more personal, showing that listening isn't just a skill, it's something built into the space itself.

Listening That Empowers Listening should lead to action, and that includes listening to the people who care for you. When frontline staff are asked what's wasting time or making care harder, they often have smart, simple fixes. At Hawaii Pacific Health, a program called "Getting Rid of Stupid Stuff" led to hundreds of suggestions, including one that saved nurses 1,700 hours a month by removing a pointless documentation rule. When staff are empowered to speak up, care becomes more efficient, less frustrating and better for everyone.

Listening That Fosters Resilience Caring for others is demanding, and when health care workers are supported, they're better able to support you. Simple acts like sharing meals and stories with colleagues can help reduce burnout and build emotional strength in those who are caring for you. Some hospitals schedule time for these peer connections, creating space for reflection and support. Ask your provider how their health care system supports its workers.

Listening Is Kindness

Berry and his co-authors write that deep listening benefits all parties: clinician-to patient; clinician-to-clinician; leader-to-clinical and non-clinical staff. It's a cultural shift that starts with values. "Do you care enough to listen?" they ask.

For patients, this means you should feel empowered to speak up and expect to be heard.

"Your experiences, concerns and insights are not just helpful, they're essential," Berry said. "And when your care team listens with empathy and curiosity, it leads to better decisions, stronger relationships and more personalized care.

"Kindness is not a luxury in health care, it's a necessity. And true listening is one of its most powerful expressions."

Read more …Why listening may be the most powerful medicine

Research led by investigators at Mass General Brigham suggests that the health benefits of more aggressive blood pressure control outweigh concerns about overtreating people with high blood pressure readings. Results of the simulation study are published in Annals of Internal Medicine.

The study used data from the Systolic Blood Pressure Intervention Trial (SPRINT) trial, the National Health and Nutrition Examination Survey (NHANES), and other published literature to simulate lifetime health outcomes -- including heart attack, stroke, and heart failure -- for patients whose systolic blood pressure targets were set at <120 mm Hg, <130 mm Hg, and <140 mm Hg. Recognizing that blood pressure medication comes with side effects, the researchers also simulated and compared the risk of serious events resulting from the treatment.

The simulation model also accounted for common errors in patients' blood pressure readings based on what has been observed in routine clinical practice.

Even when including this error rate, the simulation model found the <120 mm Hg target prevented more cardiovascular events, such as heart attacks, strokes, and heart failure than the <130 mm Hg target. However, the lower target led to additional adverse events related to treatment, such as falls, kidney injury, hypotension, and bradycardia. The lower target also increased overall healthcare spending due to increased antihypertensive use and more frequent visits with clinicians.

Comparing the cost-effectiveness of the three blood pressure targets with typical levels of measurement error, the researchers found the <120 mm Hg target was cost-effective, associated with a cost of $42,000 per quality-adjusted life-year gained.

"This study should give patients at high cardiovascular risk and their clinicians more confidence in pursuing an intensive blood pressure goal," said lead author Karen Smith, PhD, an investigator at the Department of Orthopedic Surgery at Brigham and Women's Hospital, a founding member of the Mass General Brigham healthcare system. "Our findings suggest the intensive <120 mm Hg target prevents more cardiovascular events and provides good value, and this holds true even when measurements aren't perfect."

Smith also cautioned, "Our results examine the cost-effectiveness of intensive treatment at the population level. However, given the additional risk of adverse events related to antihypertensives, intensive treatment will not be optimal for all patients. Patients and clinicians should work together to determine the appropriate medication intensity based on patient preferences."

Authorship: In addition to Smith, Mass General Brigham authors include Thomas Gaziano. Additional authors include Alvin Mushlin, David Cutler, Nicolas Menzies, and Ankur Pandya.

Funding: The study was funded by the National Science Foundation and the National Institute of Neurological Disorders and Stroke.

Read more …How low should blood pressure go? New study has the answer

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