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Health Conversations: Six ways to engage patients


Patients are much more likely to follow advice if they feel they are part of the decision-making process.

A growing body of research suggests that people who are actively involved in their health and health care tend to have better outcomes. As a result, many public and private health care organizations are employing strategies to better engage patients. It is especially important during a crisis like the pandemic that providers take steps to engage their patients when speaking with them about important health care issues.

Engaged patients feel empowered and respected, which makes them more likely to build rapport with their provider. Without this trust, patients may tell providers what they think the practitioner wants to hear, rather than what they are actually experiencing. Patients are also much more likely to follow advice if they feel they are part of the decision-making process, rather than they are being told what to do.

Here are six practical suggestions for how to enhance your patients’ engagement in your conversations about their health care.

1. Start with open-ended questions

Much of health care today involves helping patients manage conditions whose outcomes can be greatly influenced by lifestyle or behavior changes. Using motivational interviewing techniques, such as asking open-ended questions—rather than yes or no questions—allows patients to express their thoughts about their health and lifestyle choices. This can open up the conversation and give you much more insight into the patient’s perspective.

2. Listen before giving advice

Health care providers need to convey that their relationship with the patient is a partnership. This means taking the time to genuinely listen. While you may be the expert when it comes to medicine, the patient is the expert regarding their body and life. Let them know that you respect their experience and are taking it into consideration when making decisions about the plan of care.

3. Ask permission

One powerful way to express respect is to ask for your patient’s permission to discuss a health topic, especially if it is one that may be sensitive. For example, you can say, “Nutrition plays an important role in diabetes management. Is it okay if we discuss your nutrition today?” By asking permission, you are respecting the patient’s autonomy and agency over their own health. If the patient does not give permission to talk about a particular topic, you should respect that decision.

4. Learn to move slowly

If your patients are resisting a discussion, try simply offering additional resources on the topic. Let them know that, whenever they are ready to discuss the topic, the door is open. If they do give permission to discuss a sensitive topic, make sure to use motivational interviewing and ask open-ended questions. For example, you could ask, “How is your weight affecting your quality of life and your health?” or “How do you feel about your alcohol consumption?” Your tone should convey empathy and a genuine desire to help the patient.

5. Ask about any barriers that might exist to following your advice

Giving advice without asking patients about possible barriers can make them feel you do not understand or care about their circumstances, needs or concerns, and thus cannot really help. At that point, they are more likely to discount any information or advice you provide. Let them know you sincerely care about any hurdles they may face in following your advice and develop strategies with the patient to overcome his or her barriers.

6. Offer options

When it comes to encouraging health changes, especially for complex behaviors such as eating or physical activity, avoid the “Righting Reflex.” This is the common impulse to want to “make things right” when we see a problem. But instead of telling the patient what to do, try to engage them in the decision by asking for their ideas. If the patient does not have any ideas, offer two or three options and let him or her decide which seems like the best fit. Once a decision has been made, summarize the plan and verify that the patient feels confident in their ability to follow through with it.

Your patients need to know that you hear and see them as individuals with opinions, feelings and experiences that matter. Using these six techniques will help to convey respect and make it more likely they will engage in their healthcare plans. And this will help them — and you — achieve better outcomes.

About the Author

Karli Burridge, PA-C, MMS, FOMA is a board-certified Physician Assistant and a Fellow of the Obesity Medicine Association. Ms. Burridge earned her Certificate of Advanced Education in Obesity Medicine in 2017. She is the President of PAs in Obesity Medicine, and serves on the Board of the Illinois Obesity Society. She is a co-author of the Obesity Algorithm, and recently released a book on developing an obesity management program. Her book, in addition to other resources for healthcare providers who want to incorporate obesity medicine into their clinical practice, is available on her website, GainingHealth.com

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