General Communication Tips

In The Resilient Physician by Wayne and Mary Sotile, several guidelines to effective communication in any context are suggested:

1. Be assertive. Passivity in communication can be a barrier, as can being aggressive. Assertive communication requires clear and direct requests, being positive, and being respectful. Consider using “and” in statements, rather than “but.” Research indicates that when people hear the “but” in a statement, they will tune out any positives that precede it.

2. Be warm. Highlight positives frequently. Give honest compliments whenever possible. Pay close attention to your body language. Is your face relaxed? Do you smile? How is your eye contact? Are you an engaged listener? How is your tone of voice?

3. Show empathy. The key is listening actively and tuning into the other person’s experience. Remember that over ninety percent of the message comes from nonverbal cues. They suggest the following:

  • Clear your mind of distractions.
  • Focus on the speaker. Don’t interrupt.
  • Look for nonverbal communication cues.
  • As you are listening, ask what the person truly wants you to hear.
  • Summarize to them what you think they are saying, without judgmental statements.
  • Watch for how they respond to your responses. Are you making them feel relieved and cared for?
  • Clarify, if they feel you don’t understand.
  • Discuss what can be done to resolve the situation.
  • Validate what the other person feels, even if you disagree.

A quick mnemonic that can be considered (as referenced by Sotile and Sotile from The Patient’s Story, by Smith and Engel) is NURS

  • Name the emotion
  • Show you Understand
  • Show Respect
  • Support in a partnership approach

4. Listen. Spend as much time listening as you do talking. Some people like the LADDER mnemonic:

  • Look at the other person
  • Ask questions
  • Don’t interrupt
  • Don’t change the subject (without permission)
  • Curb your emotions
  • Respond – reflect what they say, validate it, offer support, keep a partnership approach, be respectful, and don’t over- or under-react to what the speaker says.

5. Be specific. Specify where you are, and make sure your nonverbal behaviors are congruent. Be explicit about how to act on the conversation, or follow up on something.

6. Self-disclose with discretion. Share some when it is relevant, but don’t shift the focus of the conversation.

7. Use humor appropriately.

8. Select positive words. Avoid “don’t, won’t, didn’t” and “You better…”

9. Match the pace of the person to whom you are speaking. You can then modify the pace to where you would like it to be.

10. Check your hearing (literally).

Tips for Talking to Patients

Here are a few tips from The Resilient Physician that tie into specifics of what to do in patient interactions:

  • Apologize if you kept them waiting
  • Acknowledge them prior to the exam
  • Use their name
  • Demonstrate a knowledge of their personal or family history
  • Tell them what you will do during the exam before you do it
  • Sit, if you can
  • Touch their arm or shoulder while examining.
  • Ask open-ended questions sometimes.
  • Listen
  • Make appropriate eye contact
  • Inquire about the range of their concerns
  • Apologize for and explain interruptions
  • Involve the patient in planning treatment

Here are a few other general suggestions:

  • Focus on why they are really at the visit. Where do you sense they want to focus?
  • Don’t avoid/exclude the emotional, social, spiritual, and other potential influences on how they communicate.
  • Don’t hesitate to ask, “How can I help you?”
  • If you don’t know, just say so. You can always tell them that you will do some checking and get back to them.
  • Take time to tune in to your own needs and emotions. How might they influence your communication at the moment?


Websites – American Academy for Communication in Healthcare – has extensive links and other resources, including a free trial of (see below) – contains a number of online communications skills modules, including a free demonstration – American Balint Society. Resources on conducting Balint groups, support groups that focus on the challenges that arise for healthcare practitioners – Institute for Healthcare Communication – offers communication training courses – General guidelines from site about how to improve communication in the workplace – Wikihow article on how to communicate more effectively using body language… – guidelines from ACP on communicating bad news – Northwestern University Center for Communication in Medicine Website. Includes abstracts of their research findings

Journal Articles

Seaman, B. Charting the doctor-patient relationship – nice general overview of physician-patient communication and what some of the research shows

Travaline, et al. Patient-Physician Communication: The Why and the How – helpful review of the research and good suggestions surrounding how to overcome specific communication barriers

Dugdale, et al. Time and the Patient Physician Relationship – observations surrounding how health providers can best spend their time

Lee SJ – Enhancing Physician-Patient Communication – from the journal Hematology, focuses in great detail on breaking bad news, working with people feeling intense emotions (anger, anxiety, depression), shared decision making, and understanding patient perspectives

Zoppi and Epstein, Is Communication a Skill? Communication Behaviors and Being in Relation

Archives of articles on communication from the Journal of the American Medical Association

McGill University Library – nice array of links and full-text articles centering on physician-patient communication.

Steward M. Effective physician-patient communication and health outcomes: A review. Can Med Assoc J. 1995;152:1423-32. – Science News article summarizing study findings relating physician communication to health – aafp article on ways to improve communication. Has a number of useful tips


Books by the American Medical Association

Berent IM, Evans RL. The Right Words: The 350 Best Things to Say to Get Along with People. NY: Warner (1992)


“We are healed of a suffering only by expressing it to the full.”
-Marcel Proust

“The colossal misunderstanding of our time is the assumption that insight will work with people who are unmotivated to change. Communication does not depend on syntax, or eloquence, or rhetoric, or articulation but on the emotional context in which the message is being heard. People can only hear you when they are moving toward you, and they are not likely to when your words are pursuing them. Even the choices words lose their power when they are used to overpower. Attitudes are the real figures of speech.”
-Edwin Friedman

“Be sincere; be brief; be seated.”
-Franklin Delano Roosevelt

“Generally speaking, the first nonviolent act is not fasting, but dialogue. The other side, the adversary, is recognized as a person, he is taken out of his anonymity and exists in his own right, for what he really is, a person. To engage someone in dialogue is to recognize him, have faith in him. At every step in the nonviolent struggle, at every level we try tirelessly to establish a dialogue, or reestablish it if it has broken down.”
-Hildegard Goos-Mayr