There is a clear difference between hearing and listening. Effective listening requires energy and discipline.

In his book How to be a master coach Joseph O'Connor identified four levels of listening:

Hearing €“ This is the most superficial level, whereby we register sound waves. You do not have to pay attention to someone to hear them.

Listening to €“ The pharmacist listens to the patient, but has a question in their mind: 'what does this mean to me?' You are listening from inside your own experience, using the patient's experience to trigger your memories. This is regarded as an everyday level of listening and is adequate for everyday conversations, but not for a patient consultation.

Listening for €“ The pharmacist at this level is listening for something the patient says. The pharmacist may have an idea and is filtering what the patient is saying and selecting in order to make a judgement.

Conscious listening €“ This involves no judgement and minimal internal dialogue. The pharmacist is actively seeking to retrieve information and understand the patient. This is the optimal listening level when conducting any form of patient consultation.

Mr Covey also describes several levels of listening that include ignoring, pretending to listen, selectively choosing what to listen to and paying attention to certain words.

A fifth level is emphatic listening. While active or reflective listening involves mimicking what another person says, empathic listening means listening with the intent to understand. It allows the pharmacist to understand how the patient sees their world, you understand their paradigm and you understand how they feel.

'In empathic listening, you listen with your ears, but you also more importantly listen with your eyes and with your heart. You listen for feeling; meaning.'