Doctors, Magic and Lessons in Patient Communications

By Stewart Gandolf, Chief Executive Officer

Editor Note: Our guest post today is by Dr. Neil Baum, MD, and is adapted and condensed from his article titled, Doctors and Magicians: What We Can Learn from Wizards, and used with permission.

One of my hobbies is magic and I have found that there are principles in performing magic that apply to our interaction with patients. These are not meant to fool or deceive our patients but have the purpose of enhancing communication.

Here are a few ways that magicians make use of mental processes to better engage the audience and hold attention. Doctors can adapt these techniques to enhance patient compliance and improve healthcare.

Patients Focus on Only One Thing

The success of magicians shows that we can only pay attention to one thing at a time. Yes, we may try to multitask our daily lives, but the reality is that we are only able to focus on one task at a time. The problem with the idea of multitasking is that the brain is not set up to switch tasks that way.

Doctors need to be sure they have their target’s attention where they want it. If the patient is distracted by something external, or worse, by something else the doctor is doing, such as looking in the chart or at the computer, the key points of the discussion between the doctor and the patient will be missed.

For example, if the doctor is interrupted by a phone call or a knock at the door by a nurse wanting to ask the doctor a question, this will cause both the patient and the doctor to lose focus, and the ability of the doctor and the patient to get back on track becomes compromised. Therefore, it is recommended that you leave multitasking to the telephone operators, and instead give your undivided attention to your patients when you are eyeball to eyeball with the patient.

Motion Attracts our Attention

Ever wonder why doves are such popular props with magicians? The explosive burst of white, flapping wings as they fly off is guaranteed to draw every eyeball in the audience. The ability of the birds to hijack the viewers’ attention gives the performer a huge window of opportunity to start the next stage of his or her illusion.

Our brains are wired to respond to motion – in prehistoric times, movement might be a threat like the saber tooth tiger at the cave entrance, or perhaps a deer caught in the thicket. Whether you are presenting to a group, or even speaking to a single patient, use motion to grab the attention of your audience or patients and use the motion to focus it where you want it.

Big Motions Beat Little Motions

If you were watching a magician standing on the stage and he made a small, quick move to his pocket, you would certainly notice it. Magicians know that, and prevent you from seeing their small moves by distracting you with a big move – pulling a colorful scarf out using a sweeping gesture with their other hand. They know the audience will tune out the small move in favor of paying attention to the big one.

If you are speaking to a patient and you want to emphasize three recommendations for good health raise your hand and show your index finger as you mention the first point, show two fingers as you state the second point etc.

The Unexpected Attracts Us

When I watch a magician, I’m always trying to pay close attention to spot any “shady” moves. It’s rare to spot a skilled magician’s tricks because he is disguising some moves as expected or normal actions.

For example, if he scratches his ear, adjusts the cuff on his shirt, or makes another innocuous move we are familiar with, our brains tune it out as expected and uninteresting. On the other hand, if he placed his palm on top of his head or raised his left arm for no apparent reason, we’d all be watching with much greater attention or scrutiny.

Much as our brains focus on motion, they also focus on novelty. Surprising your patient with an unexpected gesture, a novel sound, or unfamiliar image will get him or her to look at and analyze what she is seeing. For example, if you bring out a sample medication or handout and tell the patient you have a new treatment option that might be effective for their condition, this will likely resonate with your patient.

Offering a patient samples or a voucher for a month of free medication is something not expected by the patient. If you are sponsoring a free healthcare screening, giving the patient a flyer with the date, time, and location of the screening will be far better than merely mentioning the screening.

Mirror Neurons Engage Us

One reason we don’t notice when a magician scratches his nose but slyly palms a coin at the same time is that we can easily relate what it feels like to scratch our nose. When the magician is performing that action, if we notice at all, our mirror neurons are lighting up as if duplicating that action ourselves. Magicians exploit this phenomenon with “decoy actions.”

Even though physicians will never try to disguise sneaky actions, there is a lesson here. You want to avoid actions that will signal the patient something negative is happening. Make every effort to avoid yawning in front of a patient as this signals to the patient that you are bored with the discussion. You also want to avoid putting a hand on the doorknob when you are still speaking to the patient. This signals the patient that you are mentally done with the conversation and are eager to leave.

Bring closure to the patient interaction by asking the patient if they have any additional questions. Then use your palm up hand to invite the patient to the door and let the patient exit first and you follow. This demonstrates that the patient has brought closure to the doctor-patient interaction and your showing respect to the patient by allowing the patient to exit first.

Cut the Chatter

If you’ve ever been to a magic show, either on a stage or close-up, you know that the magician often keeps talking. In essence, the magician’s patter is another stream of information for your brain to process, and the overload makes it less likely that you will spot what deception is taking place. You can see this phenomenon in action in other media, like commercials, and you will observe that the voiceover doesn’t conflict with important information on the screen.

Physicians are seldom are known for having a stream of chatter. But excessive verbiage may distract your patient from hearing your treatment recommendations. The same applies to physicians communicating with patients.

If you are showing the patient a trend in their weight, their blood tests, or an x-ray, point out the pertinent data or finding on the x-ray, and then pause your discussion to allow the patient to comprehend or digest the information.

Bottom Line: Magic has likely been around in some form at least as long as marketing and public relations, and physicians would do well to learn from prestidigitators and use some of their techniques in our interaction with our patients.

Neil Baum, MD

Some of the content in this post is based on information from Sleights of Mind: What the Neuroscience of Magic Reveals about Our Everyday Deceptions, by Stephen L. Macknik. Susana Martinez-Conde, and Sandra Blakeslee.

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Neil Baum, MD