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Five Words that Improve Patient, Physician Communication


Much of great customer service medical practices comes down to whether you can help patients differentiate their wants from their needs.

We’ve recently discovered magic words: “I hear what you’re saying.”

It really doesn’t matter what the patient, employee, colleague or spouse is saying, these words help the person confronting you with their “needs” relax enough to actually listen to and accept your reply.

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In the clinic, we see this all the time. An obvious example is the parent who “needs” antibiotics for their child’s cold, meanwhile the CDC has declared misuse of antibiotics as a serious threat to public health. Forty years ago, the doctor would have rolled his eyes and said, “Now mother, that’s not what he needs.” (In fact, this is a true example that Terence’s mother loves to share.) Today, we know better and utter the magic words, “I hear what you’re saying…” followed by, “…and that is a miserable cold. We should talk about options.”

“I hear what you’re saying,” works on the phone too. For example, if triaging a child with a low-grade fever that started that morning and the family “needs” the child seen right away.  As trained and experienced providers, we know clinically that the best treatment is watchful waiting, but our patient isn’t going to listen to us give advice until we acknowledge that we’ve heard what they said.  And so we say, “I hear what you’re saying. Fever does worry parents, but I’m not worried and here’s why…”

For administrative purposes, it can be trickier as most patients are more comfortable confronting an administrative staff member than a clinical one. This past month we were swarmed by parents who “needed” their kid’s physical that day so that the kid could start practice the next day. By starting our reply with, “I hear what you’re saying,” it calmed the panicked parent enough to really hear us when we explained that we have hundreds of patients who all want an appointment today and that’s why we e-mailed the parent three months ago letting them know it was time for the child’s well exam.

Our most challenging audience, though, is our colleagues. From the physician who “needs” to be off call every weekend to the executive who “needs” tech support to miraculously make the new EHR system perform exactly the same way as the old system, we’ve come to realize that we’re never going to be able to effectively communicate with each other until we say, and mean, those magic words: “I hear what you’re saying.”

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