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Doctor Uses Jazz to Tune up Physician Communication

June 06, 2014

Paul Haidet, MD, applies lessons gleaned from his lifelong love of jazz to teach physicians how to better communicate with patients.

Every time Paul Haidet, MD, goes into the clinic, he thinks of Miles Davis.


Paul Haidet, MD

The legendary jazz musician might not be your typical inspirational figure for a general internist, but Davis has taught Haidet some vital lessons.

Haidet has fused his professional career with his lifelong passion for jazz music and in the process, discovered how together the two can improve healthcare communications.

Mixing medicine and jazz by studying physician-patient interactions, Haidet has learned how the relationship between the two can be greatly improved through improvisation, a vital aspect of jazz music.

During his time at Penn State as director of medical education research and as a professor of medicine, humanities and public health sciences, Haidet has taught a class on this theory, hoping to help young physicians craft solid traits when they begin interacting with patients.

If he can create some jazz fans along the way, he figures that's an added bonus.

Communications Breakdown
Trained as a health services researcher, Haidet developed an interest in healthcare communications. After years of researching physician-patient communication, he found that medical communication, when done well, is an inherently improvisational activity.

Since he was three years old, Haidet has been a fan of jazz music, even spending time as a jazz DJ in college. Seeing that jazz relies heavily on improvisation, he saw how the music can benefit the medicine.

"Jazz is a musical conversation and for that conversation to be harmonious and interesting, you got to not only play your own solo, but you've got to be able to listen to the meaning that the other musicians are playing and you have to have a musical conversation, he says.. "That's when jazz is at its best, and to be honest, that's when medicine is at its best too."

It's why he thinks of Miles Davis when he begins to treat patients. Davis never lectured listeners on the bandstand, but rather worked the musical process. When Haidet enters the clinic, he aims to accomplish similar results with patients.

"I try to work the communicative process so that I can understand where they are coming from and so that I can let them pull out the information from me that they really need, so that we can make decisions together, rather than telling them what to do or rather them making the decision and telling me what to do" said Haidet.

Talk Isn't Cheap
Haidet stresses that physician-patient communication is very important from a quality standpoint. Noting that more than 30,000 articles have been written on the subject, he notes that patients are not only more satisfied and trusting when communication is optimal, but they are less likely to sue and have better healthcare outcomes.

Whether it's a patient having lower blood pressure, diabetes patients having faster symptom resolution, or headache patients receiving more preventative medicine interventions, Haidet sees that these outcomes are all tied back to the quality of the communication process.

"Every decision that gets made funnels through a conversation between either a doctor or another practitioner and a patient," says Haidet. "Communication is the central process."

The Art of Improv
While improvisation is an important tool to utilize during physician-patient interactions, that doesn't mean that doctors should throw away their rulebooks and checklists just yet.

Medicine is not an exact science, Haidet says, and the depth of its complexity means that physicians have to be able to navigate between situations that are common and have clear protocols, and the tougher cases that require a physician to call upon all of their algorithms and medical knowledge to solve.

Not every situation is documented in the rules, so while consulting medical literature and other pieces of text is part of the process, Haidet emphasizes that there is always a step beyond those guidelines.

"Good improvisation is built on a foundation of the basics," said he says. "So there is a place for the knowledge and for the textbooks, but the textbooks are a point of departure. They are not the end."

That's the message that carries through Haidet's class at Penn State. "Jazz and the Art of Medicine" is a course fourth-year medical students can take in order to learn about the importance of communication.

Haidet teaches the students four fundamental improvisational skills through the course:

  1. Managing the tension between structure and freedom.
  2. Finding meaning in another person's communication.
  3. Finding your voice as a communicator.
  4. Using space effectively, i.e. allowing the patient to speak, rather than interrupting during the course of a conversation.

Is anyone of the four more important than the others? Haidet doesn't have an answer yet.

"That is the $64,000 question," says Haidet. "That question has not been researched yet. I find myself thinking they're all important, but important in different ways, and different contexts. "

The "textbook" for the class is the classic jazz recording, Miles Davis's Kind of Blue, and the class is a mixture of listening exercises, practice, and videos.


Miles Davis's Kind of Blue

"We do a combination of jazz listening exercises where the students listen to a number of jazz musical selection and we talk about what's going on with the concept within jazz and then we translate that into medicine with a number of doctor-patient videos, and then the students go out into clinics in the specialty that they are going to go into and they practice the concepts," says Haidet.

He enjoys being able to open new minds to the genre, and get some personal satisfaction from seeing his students pick up something else from the class: A love for the music itself.

"We do ask them how well they like jazz before and after the course. We've seen a small bump in those numbers," said Haidet. "As an old jazz prophet I'm always trying to turn new people on to jazz, but that's not really the goal of the course. I am always encouraged though."

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