It's clear that Leroy can feel comfortable enough to offer responses to the suggested management option after another medication is discussed. 

This was facilitated in the way the GP gathered the information in the first part of the consultation. 

He leans in while explaining about the prostate and makes himself smaller- this refers to a concept called 'Status' and shows awareness that consultations between Doctor and Patient can be disrupted by the way the clinician communicates. 

As in other cases, communication refers to the Mehrabian ratio of 

• 7% of communication are the words spoken
• 38% of communication in the tone of voice- the rhythm, pace, pitch and inflections of speech
• 55% of communication in the body language- eye contact, facial expression, hand gestures and posture

If the patient feels they are of a lesser status than the Doctor then this power dynamic becomes apparent, either through the words they use, the tone they express the words in or in their body language. 

Here the GP uses frequent pauses, he checks and uses facial expression to raise his eyebrows and ensure Leroy is keeping pace. Each management choice, from medication for prostatic enlargement, keeping a symptom diary, consideration of overactive bladder influences

As well as attention to the non-verbal aspects of communication, what language of shared decision making does the GP use here?

Some may argue it looks unsure, but the tentative and suggestive approach here is a successful one, and Leroy feels comfortable enough to express the impact of his symptoms on him and those around him. As you can see from his feedback, he appreciates knowing the mechanics of the issue and the process of checking his urine output, appealing to his Engineering skills!

Task

Try saying the same sentence with different emphasis on words. See how many meanings each version has. 

• What do you think? Asking for a response
• What do you think? Implies you may have been thoughtless
• What do you think? Directing the question specifically at an individual or group
• What do you think? (in a sarcastic tone) implies that the answer was obvious and you didn't see it
• What do you think? Inviting you to agree with them- about a nice outfit, a tidied room or a piece of art