A Clinicians’ Guide to Better Patient Communication

Medical school teaches us many skills, like how to decipher symptoms, perform a physical exam, and document medical history. But it doesn’t always teach us the skill of patient communication. In fact, research indicates that clinicians “listen” to patients for a mere 11 seconds, on average, before interrupting.

Respectful, open communication vastly improves a patient’s outcomes. This is especially true for patients whose conditions may provoke distrust and miscommunication — depression, anxiety, trauma, and ADHD, to name a few. With stronger patient-provider communication, we are more likely to win over patients and improve treatment adherence. Take the following communication strategies to your next patient appointments.

1. Shift to Open-Ended Questions

Do close-ended questions — which only produce “Yes,” “No,” and “I don’t know” answers — dominate your interactions with patients? You’re sure to obtain rich, insightful information about a patient’s health and build trust if you shift to open-ended questions. The trick is to invite patients to tell you about a topic. Take social activities.

• Instead of: “Do you spend time with friends?”
• Try: “Tell me about your friends and the activities you do together.”

• Use empathetic responses as your patient shares.
  • Normalize (e.g., “I can understand why you would feel scared if…”)
  • Self-disclose (e.g., “We never seem to stop worrying about our kids, even as adults.”)
  • Highlight and amplify (e.g., “I’m impressed with how clearly you’ve communicated your concerns.”)

• Look for shame and stigma, which makes it difficult for patients to trust and open up. Patients with ADHD, for example, often develop shame as a result of criticism and negative feedback from peers and authority figures.
  • Say, “I sense that you’re feeling some shame. Is it something I said? Is there something going on in your life that’s causing it?”

• Avoid blaming and lecturing patients, making dismissive comments, and minimizing their complaints.

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2. Listen. Don’t Rush to the Treatment Plan.

It’s second nature for us — because it’s our job — to immediately devise treatment plans in our heads as patients communicate their concerns. But if your attention is on plans and processes, then it’s not on actively listening to your patients. Momentarily abandon all agendas and be present as your patient shares.

• Listen for needs. The basic human needs — to feel loved, to be important, to belong, and to be good at something — are particularly relevant here. When these needs are not met, depression, anxiety, and other mental health conditions are often the result. What does your patient want you to hear and understand about them and these needs?
• Look up from your screen. Eye contact lets your patient know that you are present.
• Consider all forms of communication, including body language, facial expression, and tone. Be mindful of your expressions, posture, and affect, too.
• Don’t try to get ahead of the patient. You know a lot about treating conditions in your specialty, but your patient doesn’t. Don’t fall into the “I know what’s going on” trap and risk cutting your patient short. Trying to bring your patient up to speed will only result in pushback. See problems from the patient’s perspective, not the clinical one.

3. Share Your Understanding

Clinical empathy is achieved when your patient sees that you understand what they’re saying and feeling. You don’t need to mirror the patient’s emotional state, but you do need to recognize and acknowledge it. You may not agree with the patient’s concerns, but they should feel you’re taking them seriously.

To convey understanding, restate the patient’s concerns in your own words. Consider the following openings:

• “So, you’re saying…”
• “It sounds like…”
• “You’re wondering if…”
• “I hear you saying…”

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4.Negotiate, Don’t Impose

After sharing your understanding of your patient’s health concerns, it’s time to share ideas for how to move forward. This is not a one-way conversation to force a treatment plan on your patient. This is a two-way exchange in which you invite the patient — who is now more inclined to open up — in shared decision-making about their health. Find areas that you both agree to focus on first.

Preface your ideas with the following scripts:

• “Would it be okay with you…”
• “What do you think about…”
• “Does it make sense to…”

Throughout the exchange, remember that the patient is the most important member of the health team. Emphasize that you can’t do this without them and their buy-in, which may mean compromising on a treatment plan.

Let the patient know that this won’t be your last meeting. Explain that you are available to troubleshoot and modify their treatment plan if needed.

Encouraging Words Patients Want to Hear

• “There is hope for your future, despite these problems.”
• “You are not alone in dealing with this problem.”
• “Your condition is not your fault.”
• “I understand what you are saying and navigating.”
• “You have many strengths.”

The Power of a Minute

You may think it impossible to implement these strategies within the short timeframe of an appointment. Yes, following these strategies may extend your patient visits, but not as much as you think. What’s more, investing in effective communication early on will save you and your patients time in the long run, as you’ve invested in truly understanding needs and collaborating first. If time remains an issue for implementing these strategies, consider splitting appointments into two or more sessions.

If you only have one minute with a patient, don’t spend that minute leaving. Your full, undivided attention — even for just 60 seconds — can go a long way in making patients feel respected and heard.

Communication in Healthcare: Next Steps

• Download: New! The Clinicians’ Guide to Treating Complex ADHD
• Read: How Collaborative Care Models Deliver Quality ADHD Care – Seamlessly
• Read: “Collaborative Care” Improves ADHD Symptoms in Children

The content for this article was derived from the ADDitude ADHD Experts webinar titled, “For Clinicians: Common Treatment Barriers for Patients with Depression, Trauma” [Video Replay & Podcast #471] with Lawrence Amsel, M.D., which was broadcast on September 13, 2023.

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Updated on January 15, 2025