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More Than Words: Body Language and Patient Communication

Unspoken messages matter.

Christina Stach ’25 learned this truth while working in the Vallejo Police Department in the evidence unit where she was schooled in the basics of understanding body language. She shared this knowledge in a Medical Student Grand Rounds presentation to convey the importance of using it to communicate with patients.

Christina Stach ’25
Christina Stach ’25

“We don’t naturally think about what our body is doing when we are talking with others,” Stach says. “But when I put into practice what I learned in the police department I was able to better communicate with friends and family.” Inspired to further understand the nuances of body language, she delved into the research literature. When she read, What Everybody is Saying, by Joe Navarro, “it changed how I communicated with everyone.”

While approximately 80 percent of our interactions with each other are nonverbal—from birth, we recognize and respond to facial signals, and our body language consistently sends out clues to what we are thinking. Though these signals are unconscious, Stach says we can learn to exert control over our body language.

For healthcare providers, she says body language not only conveys how they feel about their patients but can also affect how patients perceive them.

Becoming acutely aware of her own body language, the aspiring physician recognized her preferred way of sitting with her arms and legs crossed, while comfortable for her, patients perceived it discomfort with them. She found the same to be true with eye contact. “I don’t make a lot of eye contact with people because it makes me uncomfortable,” Stach says, “but it makes others think I’m inattentive.”

Armed with that knowledge, she began uncrossing her arms and legs when in conversation, making more eye contact with less blinking, and mirroring body language to reinforce the shared conversational bond. “By uncrossing my arms and legs, I show my vulnerability and comfort—I’m saying this is a safe space where we can let our guard down. But if you must cross, cross toward the patient, or whomever you are talking with, and keep it relaxed,” she advises.

While interviewing a standardized psychiatric patient, Stach says she was unaware of how naturally she mirrored the patient’s body language until one of her classmates pointed out how easily she shifted her body language to match the patient’s. It was, she says, the result of years of experience.

“While it may take a conscious effort at first, using positive body language can help strengthen patient interactions, and once these habits become natural, you may notice your patients are more open with you and more receptive to your advice.”

Reflecting on how physician body language shapes patient interactions, Stach notes studies that report communication between doctors and patients to be a complex mix of words, gestures, expressions, postures, and eye contact. These nonverbal cues can affect rapport, patient trust, the willingness of a patient to adhere to a care plan or medications, and a patient's satisfaction with the doctor-patient relationship.

Eye level and eye contact are crucial to showing respect and gaining trust. Talking with patients at eye level is important, Stach says. “It shows them that I am here to listen to what they have to say and to make joint decisions about their healthcare.”

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Looking down from a higher eye level while talking with a patient may convey a patronizing and condescending attitude. Stach recommends that physicians lower their eye level as much as possible by sitting on a low stool facing their patient while the patient remains seated on the exam table.

Eye contact is another element of this tethered cord of attention between physician and patient. “If you are typing notes into your computer and not looking at your patient—even if you are listening and can repeat everything they say, without eye contact your body says that you are not listening,” Stach says. “When you look away from your patient, you are severing that cord and no longer have a closed space of attention with each other.”

While presenting herself as a physician who is trustworthy and collaborative, Stach says she is also alert to whether her patients are sending signals of their own as to whether they are comfortable or trustworthy.

“As new providers who will be part of a care team, we want to be on the same level as the patient rather than be seen as a figure of authority, and we want the care team to be as involved as we are,” she says. “We are all in this together and as physicians we are here to listen and collaborate rather than demand and instruct.”

And though there may be other barriers to communicating with patients, such as cultural differences and communicating through an interpreter, Stach says body language can convey a message of care and trust.

“In medicine we are often in our patient’s face during a medical exam, but when talking with them being too close may feel intrusive, especially in Western cultures where we have broader personal body bubbles,” Stach notes. “But in Eastern cultures that bubble is much narrower. So, when interacting with people from these cultures, stepping back is seen as offensive—that is something to keep in mind.”

Stach says, “Although not foolproof, being aware of body language can create a better physician-patient therapeutic alliance and improve adherence to treatment and follow up.”

Photos courtesy of Christina Stach ’25