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Practice What Your Patient is Thinking

“How can I help you hear?” The transforming power of six little words

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h184 (Published 18 February 2015) Cite this as: BMJ 2015;350:h184

Rapid Response:

Re: “How can I help you hear?” The transforming power of six little words

Enunciating and speaking clearly is often the most important factor for hearing accurately, especially for high tone hearing loss. Competing noise becomes increasingly difficult with aging. Speaking louder does little to overcome this, as opposed to waiting for other noise to subside (passing vehicle, jet, food cart in a hospital corridor, competing mobile phone conversation, etc.). Unfamiliar accents are also more difficult when speech is fast.

Young people, and especially those who speak very fast with poor diction, can be encouraged to decide whether they wish to be understood. If not, most people can live with that, and ignore them. If communication is important, then they should be encouraged to ask the proposed question and listen to the answers.

In people taking anticholinergic drugs (now a huge range of medications), diction is improved immediately by a sip of non-alcoholic liquid and a mouth rinse to lubricate the tongue and lips.

Tom Perry, M.D.

Competing interests: Sometimes I prefer NOT to hear what people are saying.

04 March 2015
Thomas L. Perry
physician, university professor
Dept. of Anaesthesiology, Pharmacology & Therapeutics, University of B.C.
S-139, UBC Hospital, 2211 Wesbrook Mall, Vancouver, B.C. V6T 2B5