Physicians need to "listen" with their eyes, according to a doctor who believes patients sometimes say "yes" while their bodies are really saying "no, no, no" to treatment.

The doctor who understands that body language can deal with the conflict and try to help instead of sending the patients away unhappy, said Dr. Cecile Carson, chief of behavioral and psychosocial medicine at Genesee Hospital."It's not what we say, but how we say it and how a patient hears it, that makes a difference," agreed Dr. Robert E. McAfee of Portland, Me., a member of the American Medical Association board of trustees. "It goes to the question of who you want for your doctor. If you come to me and keep coming back to me, it's probably because I, quote, tend to hit it off with you, unquote."

Carson, supported by a grant from the National Fund for Medical Education, has adapted non-verbal communication theories - shrugs, folded arms and glances - and is teaching medical students and lecturing around the country.

She also emphasizes "pacing" - adjusting body movements to a patient's movements in order to make a patient feel more comfortable. "So if a patient has her arms crossed, the doctor might want to cross his arms. If the patient is leaning forward, the doctor might want to lean forward."

Carson believes non-verbal communication is a skill that can be acquired with practice and that even people who recognize and respond to many non-verbal actions need to be taught.